• Title/Summary/Keyword: Nuclear medicine image

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Lung Uptake of $^{99m}Tc-sestamibi$ during Routine Gated Exercise SPECT Imaging : Comparison with Left Ventricular Ejection Fraction and Severity of Perfusion Defect (일상적인 운동 부하 게이트 심근 관류 SPECT에서 $^{99m}Tc-sestamibi$ 폐섭취 : 좌심실 구혈률과 관류 결손 정도와의 비교)

  • Jeong, Shin-Young;Lee, Jae-Tae;Bae, Jin-Ho;Ahn, Byeong-Cheol;Lee, Kyu-Bo
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.2
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    • pp.83-93
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    • 2003
  • Background: Lung-to-heart uptake ratio (LHR) in $^{201}Tl-chloride$ myocardial perfusion scan is believed to be a reliable marker for left ventricular (LV) dysfunction, but the clinical value of LHR is controversial for $^{99m}Tc-MIBI$ imaging. Furthermore, most of results suggesting lung uptake of $^{99m}Tc-MIBI$ as a potential marker for LV dysfunction used immediate post-stress images, instead of routine images acquired 1 hour after tracer injection. The goal of our study was to investigate whether LHR evaluated with routine gated $^{99m}Tc-MIBI$ imaging can reflect the degree of perfusion defect or left ventricular performance. Subjects and Methods: 241 patients underwent exercise $^{99m}Tc-MIBI$ myocardial SPECT were classified into normal myocardial perfusion (NP, n=135) and abnormal myocardial perfusion (AP, n=106) group according to the presence of perfusion defect. LHR was calculated from anterior projection image taken at 1-hour after injection. Two legions of interest (ROIs) were placed on left lung above LV and on myocardium showing the highest radioactivity. Subjects were classified by left ventricular ejection fraction (LVEF), as Gr-I: >50%, Gr-II: 36-50%, Gr-III: <36% and by summed stress score (SSS), as Gr-A: <4, Gr-B: 4-8, Gr-C: 9-13, Gr-D: >13, LHR was compared among these groups. Results: In NP group(n=135), LHR, were higher in men than women ($men:\;0.311{\pm}0.03,\;women:\;0.296{\pm}0.03,\;p<0.05$). Significant difference, in LHR were found between NP and AP groups both for men and women ($men:\;0.311{\pm}0.03\;vs\;.\;0.331{\pm}0.06,\;women:\;0.296{\pm}0.03\;vs.\;0.321{\pm}0.07.\;p<0.05$). There were weak negative correlation between LHR and LVEF (r=-0.342, p<0.05) and weak positive correlation between LHR and SSS (r=0.478, p<0.05) in men, but not in women (LVEF: r=-0.279, p=0.100, SSS: r=0.276, p=0.103). Increased LHR was defined when for more than mean + 2SD value ($men{\geq}0.38,\;women{\geq}0.37$) of the LHR of the subject with normal perfusion. Increased LHR were observed more frequently in subjects with lower LVEF (Gr-I: 11.1%, Gr-II: 27.0%, Gr-III: 35.4%, p<0.05) and higher SSS(Gr-A: 14.0%, Gr-B: 5.7%, Gr-C: 18.2%, Gr-D: 40.7%, p<0.05). Conclusions: LHRs obtained from routine $^{99m}Tc-MIBI$ gated SPECT images were weakly correlated with LVEF and perfusion defect. Although significant overlaps were observed between normal and abnormal perfusion group, LHRs could be used as an indirect marker of severe perfusion defect or reduced left ventricular function.

Performance Evaluation of Siemens CTI ECAT EXACT 47 Scanner Using NEMA NU2-2001 (NEMA NU2-2001을 이용한 Siemens CTI ECAT EXACT 47 스캐너의 표준 성능 평가)

  • Kim, Jin-Su;Lee, Jae-Sung;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.259-267
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    • 2004
  • Purpose: NEMA NU2-2001 was proposed as a new standard for performance evaluation of whole body PET scanners. in this study, system performance of Siemens CTI ECAT EXACT 47 PET scanner including spatial resolution, sensitivity, scatter fraction, and count rate performance in 2D and 3D mode was evaluated using this new standard method. Methods: ECAT EXACT 47 is a BGO crystal based PET scanner and covers an axial field of view (FOV) of 16.2 cm. Retractable septa allow 2D and 3D data acquisition. All the PET data were acquired according to the NEMA NU2-2001 protocols (coincidence window: 12 ns, energy window: $250{\sim}650$ keV). For the spatial resolution measurement, F-18 point source was placed at the center of the axial FOV((a) x=0, and y=1, (b)x=0, and y=10, (c)x=70, and y=0cm) and a position one fourth of the axial FOV from the center ((a) x=0, and y=1, (b)x=0, and y=10, (c)x=10, and y=0cm). In this case, x and y are transaxial horizontal and vertical, and z is the scanner's axial direction. Images were reconstructed using FBP with ramp filter without any post processing. To measure the system sensitivity, NEMA sensitivity phantom filled with F-18 solution and surrounded by $1{\sim}5$ aluminum sleeves were scanned at the center of transaxial FOV and 10 cm offset from the center. Attenuation free values of sensitivity wire estimated by extrapolating data to the zero wall thickness. NEMA scatter phantom with length of 70 cm was filled with F-18 or C-11solution (2D: 2,900 MBq, 3D: 407 MBq), and coincidence count rates wire measured for 7 half-lives to obtain noise equivalent count rate (MECR) and scatter fraction. We confirmed that dead time loss of the last flame were below 1%. Scatter fraction was estimated by averaging the true to background (staffer+random) ratios of last 3 frames in which the fractions of random rate art negligibly small. Results: Axial and transverse resolutions at 1cm offset from the center were 0.62 and 0.66 cm (FBP in 2D and 3D), and 0.67 and 0.69 cm (FBP in 2D and 3D). Axial, transverse radial, and transverse tangential resolutions at 10cm offset from the center were 0.72 and 0.68 cm (FBP in 2D and 3D), 0.63 and 0.66 cm (FBP in 2D and 3D), and 0.72 and 0.66 cm (FBP in 2D and 3D). Sensitivity values were 708.6 (2D), 2931.3 (3D) counts/sec/MBq at the center and 728.7 (2D, 3398.2 (3D) counts/sec/MBq at 10 cm offset from the center. Scatter fractions were 0.19 (2D) and 0.49 (3D). Peak true count rate and NECR were 64.0 kcps at 40.1 kBq/mL and 49.6 kcps at 40.1 kBq/mL in 2D and 53.7 kcps at 4.76 kBq/mL and 26.4 kcps at 4.47 kBq/mL in 3D. Conclusion: Information about the performance of CTI ECAT EXACT 47 PET scanner reported in this study will be useful for the quantitative analysis of data and determination of optimal image acquisition protocols using this widely used scanner for clinical and research purposes.

Evaluation of the 256ch Flat Panel PS-PMT on Positioning Image Histogram for PET

  • Orita, Narimichi;Murayama, Hideo;Kawai, Hideyuki;Inadama, Naoko;Umehara, Takaya;Kasahara, Takehiro;Tsuda, Tomoaki
    • Proceedings of the Korean Society of Medical Physics Conference
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    • 2002.09a
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    • pp.324-327
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    • 2002
  • For a next generation PET that realizes high sensitivity and high resolution, we proposed a design of a depth of interaction detector. A unit of the detector is constructed of four stages rectangular blocks of 2 by 2 Gd$_2$SiO$\sub$5/: Ce (GSO) crystal array optically coupled to position sensitive photomultiplier tube (PS-PMT). The 256ch flat panel PS-PMT is under development by Hamamatsu Photonics K.K., JAPAN. It has large cathode area, 51.7 by 51.7 mm$^2$, and the ratio of the effective area to external size is about 90%. The feature will contribute high packing fraction, accordingly high sensitivity. The 256 anodes are arranged in 16 by 16 at intervals of 3.0 mm. So as to evaluate the detector capability for identifying crystal of interaction, we got positioning image histograms with coupling a 16 by 5 array of GSO crystals, 2.9 by 2.9 by 7.5 mm$^3$, to the PS-PMT by irradiating a gamma ray uniformly from a point source. Flat panel PS-PMT is a new promising device for PET. We need to evaluate it if its performance is sufficiency. The performance was compared to the one with a 16ch PS-PMT.

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Application of Hydrogenated Amorphous Silicon(a-Si : H) Radiation Detectors in Nuclear Medicine

  • Lee, Hyoung-Koo;Mendez, Victor-Perez;Shinn, Kyung-Sub
    • Progress in Medical Physics
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    • v.6 no.1
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    • pp.65-77
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    • 1995
  • A new gamma camera using a-Si : H photodetectors has been designed for the imaging of heart and other small organs. In this new design the photomultiplier tubes and the position sensing circuitry are replaced by 2-D array of a-Si : H p-i-n pixel photode tectors and readout circuitry which are built on a substrate. Without the photomultiplier tubes this camera is light weight, hence can be made portable. To predict the characteristics and the performance of this new gamma camera we did Monte Carlo simulations. In the simulations 128${\times}$128 imaging array of various pixel sixes were used. $\^$99m/Tc(140keV)and $\^$201/Tl(70keV) were used as radiation sources. From the simulations we could obtain the resolution of the camera and ther overall system, and the blurring effects due to scattering in the phantom. Using the Wiener filter for image processing, restoration of the blurred image could be achieved. Simulation results of a-Si : H based gamma camera were compared with those of a conwentional gamma camera.

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Architectural and Interior Design of Chosun University Hospital Medical Center (조선대학교 병원 전문진료센타 설계)

  • Park, Young-Ho
    • Proceedings of the Korean Institute of Interior Design Conference
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    • 2005.10a
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    • pp.191-192
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    • 2005
  • This project is to establish an annex clinic center under 5 floors with gross floor area of 3,000 Pyeong behind existing Chosun university Hospital main building with 600 beds. The goal of the design is connecting the new clinic center with the existing main building and completing a combined hospital that has synergy effects. Given the old condition of the hospital and characteristics of the ground, I tried to embody the image of Medical Pulse, which is very alive with strong pulse, and suggest vision of 21st century hospital. First, one main entrance as a combined hospital. For optimum access and functions, I used the entrance of existing building as the only main entrance of new combined hospital, rearrange the road in front of the main building and improve traffic system, and upgrade the image and function of combined main entrance by planning new atrium united robby that makes link to the main building easier. Second, section planning considering the optimum functions and convenience. I established 4 floors linking functionally with the existing building, minimized vertical traffic line, and enhanced convenience through barrier free environment, which is a horizontal traffic line without barriers, crucial to hospital. Third, combined zoning generating synergy effects. I linked sterilizing room with logistics center by operating room and service bridge, and arranged central treatment department horizontally, Also, by horizontally arranging cancer center and department of nuclear medicine close with PET and cyclotron center, I established identity of specialized departments.

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Evaluation of Volumetric Texture Features for Computerized Cell Nuclei Grading

  • Kim, Tae-Yun;Choi, Hyun-Ju;Choi, Heung-Kook
    • Journal of Korea Multimedia Society
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    • v.11 no.12
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    • pp.1635-1648
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    • 2008
  • The extraction of important features in cancer cell image analysis is a key process in grading renal cell carcinoma. In this study, we applied three-dimensional (3D) texture feature extraction methods to cell nuclei images and evaluated the validity of them for computerized cell nuclei grading. Individual images of 2,423 cell nuclei were extracted from 80 renal cell carcinomas (RCCs) using confocal laser scanning microscopy (CLSM). First, we applied the 3D texture mapping method to render the volume of entire tissue sections. Then, we determined the chromatin texture quantitatively by calculating 3D gray-level co-occurrence matrices (3D GLCM) and 3D run length matrices (3D GLRLM). Finally, to demonstrate the suitability of 3D texture features for grading, we performed a discriminant analysis. In addition, we conducted a principal component analysis to obtain optimized texture features. Automatic grading of cell nuclei using 3D texture features had an accuracy of 78.30%. Combining 3D textural and 3D morphological features improved the accuracy to 82.19%. As a comparative study, we also performed a stepwise feature selection. Using the 4 optimized features, we could obtain more improved accuracy of 84.32%. Three dimensional texture features have potential for use as fundamental elements in developing a new nuclear grading system with accurate diagnosis and predicting prognosis.

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Evaluation of Standardized Uptake Value applying EQ PET across different PET/CT scanners and reconstruction (PET/CT 장비와 영상 재구성 차이에 따른 EQ PET을 이용한 표준섭취계수의 평가)

  • Yoon, Seok Hwan;Kim, Byung Jin;Moon, Il Sang;Lee, Hong Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.1
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    • pp.35-42
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    • 2018
  • Purpose Standardized uptake value(SUV) has been widely used as a quantitative metric of uptake in PET/CT for diagnosis of malignant tumors and evaluation of tumor therapy response. However, the SUV depends on various factor including PET/CT scanner specifications and reconstruction parameter. The purpose of this study is to validate a EQ PET to evaluate SUV across different PET/CT systems. Materials and Methods First, NEMA IEC body phantom data were used to calculate the EQ filter for OSEM3D with PSF and TOF reconstruction from three different PET/CT systems in order to obtain EARL compliant recovery coefficients of each spheres. The Biograph true point 40 PET/CT images were reconstructed with a OSEM3D+PSF reconstruction, images of the Biograph mCT 40 and Biograph mCT 64 PET/CT scanners were reconstructed with a OSEM3D+PSF, OSEM3D+TOF, OSEM3D+PSF+TOF. Post reconstructions, the proprietary EQ filter was applied to the reconstruction data. Recovery coefficient can be estimated by ratio of measured to true activity concentration for spheres of different volume and coefficient variability(CV) value of RC for each sphere was compared. For clinical study, we compared SUVmax applying different reconstruction algorithms in FDG PET images of 61 patients with lung cancer using Biograph mCT 40 PET/CT scanner. Results For the phantom studied, the mean values of CV for OSEM3D, OSEM3D+PSF, OSEM3D+TOF and OSEM3D+PSF+TOF reconstructions were 0.05, 0.04, 0.04 and 0.03 respectively for RC. Application of the proprietary EQ filter, the mean values of CV for OSEM3D, OSEM3D+PSF, OSEM3D+TOF and OSEM3D+PSF+TOF reconstructions were 0.04, 0.03, 0.03 and 0.02 respectively for RC. Clinical study, there were no statistical significance of the difference applying EQ PET on SUVmax of 61 patients FDG PET image. (p=1.000) Conclusion This study indicates that CV values of RC in phantom were decreased after applying EQ PET for different PET/CT system and The EQ PET reduced reconstruction dependent variation in SUVs for 61 lung cancer patients, Therefore, EQ PET will be expected to provide accurate quantification when the patient is scanned on different PET/CT system.

In the examination of PET/CT, Breast-tool production and availability of using FRP to check for breast disease. (양전자방출전산화단층촬영 검사에서 유방 질환 환자를 검사하기 위해 유리섬유강화플라스틱을 이용한 유방 틀의 제작 및 유용성)

  • Kim, Gab-Jung;Jeon, Min-Cheol;Han, Man-Seok;Seo, Sun-Youl;Kim, Nak-Sang;Bae, Won-Gyu
    • Journal of the Korea Convergence Society
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    • v.8 no.9
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    • pp.175-181
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    • 2017
  • The purpose of this study is to evaluate the breast tool to improve the diagnostic value of the image in the breast examination. Breast tool was made of using FRP. And then it was compared by radioactivity counting rate and image. In the evaluation of the Breast tool, the left and right counts per $1{\mu}Ci$ are 185 counts and 189 counts, respectively. The image obtained in the prone position was close to the circle. To increase diagnostic value of image, it is considered to use Breast-tool in the breast examination.

Evaluation for the Usefulness of Copper Filters according to Mode Change in Digital Radiography System (DR 시스템에서 모드 변화에 따른 구리필터의 유용성 평가)

  • Kim, Jae-Kyeom;Kim, Jeong-Koo
    • Journal of radiological science and technology
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    • v.44 no.1
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    • pp.39-46
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    • 2021
  • This study confirmed the usefulness of the copper filter according to the mode change by comparing and analyzing the energy change according to the application of the copper filter and the change in effective dose and image quality according to the distance to the subject in the DR(Digital Radiography) system. The average energy increased when the copper filter was applied and the reduction rate by 50% of mAs was increased as the thickness of the copper filter increased according to the application of the 10 kVp rule in AEC mode. The effective dose decreased as the thickness increased when the copper filter was applied in AEC(Automatic Exposure Control) mode and manual mode according to the application of the 10 kVp rule, and the decrease rate decreased with increasing 10 kVp increments. As a result of analyzing the dicom images for AEC mode and manual mode with Image J. the PSNR(Peak Signal to Noise Ratio) values were approximate values of less than 30 dB for each mode and for each copper filter thickness. When the copper filter was applied, the average energy increased, so when the 10 kVp rule was applied, the mAs for each mode could be reduced, and the effective dose could also be reduced. However, as the distance and tube voltage increased, the reduction rate of mAs decreased, and the quality of the image was found to decrease when the copper filter was applied, but there was no difference in quality of the image when the copper filter thickness increased.

Inflammation Scan Using $^{99m}Tc-HMPAO$ Labelled Leukocytes ($^{99m}Tc-HMPAO$를 이용한 자가백혈구표지 및 그를 이용한 염증병소의 스캔)

  • Yang, Woo-Jin;Chung, Soo-Kyo;Shinn, Kyung-Sub;Bahk, Yong-Whee;Kim, Hoon-Kyo
    • The Korean Journal of Nuclear Medicine
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    • v.23 no.2
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    • pp.219-223
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    • 1989
  • Inflammation scan using radiolabelled leukocytes has high sensitivity and specificity. Several methods for labelling leukocytes have been evaluated using P-32 diisopropyl fluorophosphate (DFP-32), H-3 thymidine, Cr-51 chromate, Ga-67 citrate and Tc-99m-sulfur colloid. In-111-oxine has proved so far to be the most reliable agent for labelling leukocytes. In-111-oxine is, however, expensive, not easily available when needed, and its radiation dose to leukocytes is relatively high. Moreover, resolution of the resultant image is relatively poor. Tc-99m is still the agent of choice because of, as compared with the indium, its favorable physical characteristics, lower cost and availability. Now the technique for labelling the leukocytes with technetium is successfully obtained using the lipophilic HAPAO with higher efficiency for granulocytes than for other cells. With this technique it is possible to label leukocytes in plasma to improve the viability of the leukocytes. Inflammation scan using Tc-99m-HMPAO has been evaluated in several laboratories, and difference in methods for separation and labelling accounts for difference in efficiency, viability and biodistribution of the labelled leukocytes. We performed inflammation scan using leukocytes labelled with Tc-99m-HMPAO in three dogs 24 hours after inoculation of live E. Coli and A. Aureus in their right abdominal wall. We separated mixed leukocytes by simple sedimentation using 6% hetastarch (HES) and labelled the leukocytes with Tc-99m-HMPAO in 20% cell free plama diluted with phosphate buffer solution(Fig. 1). Uptake was high in the liver and spleen but is was minimal in the lungs on whole body scan. Kidneys and intestine showed minimal activity although it was high in the urinary bladder(Fig. 2). Uptake of labelled leukocytes in the inflammation site was do(mite on 2 hour-postinjection scan and abscess was clearly delineated on 24 hour-delayed scan with high target-to-nontarget ratio(Fig. 3, 4). Inflammation scan using mixed leukocytes labelled with Tc-99m-HMPAO is very sensitive and specific in early detection of inflammation.

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