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$^{18}F$-FDG Colonic Uptake by Oral Anti-Diabetic Drugs Including Metfomin in PET/CT Scan (PET/CT 검사에서 Metformin 성분의 항 당뇨약제에 의한 대장에서의 $^{18}F$-FDG 섭취에 관한 연구)

  • Kim, Sang-Gyu;Park, Hoon-Hee;Kim, Jung-Yul;Bahn, Young-Kag;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.50-54
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    • 2010
  • Purpose: The uptake of $^{18}F$-FDG is often observed in normal cell of colon to patients who have non-insulin-dependent diabetes mellitus and had taken anti-diabetic drugs including Metformin in PET/CT scan. In this study, the region of colon was compared between the patients who took anti-diabetic drugs including Metfomin and other patients who took the other anti-diabetic drugs through SUV measurements. Materials and Methods: A hundred eighty patients were studied. 120 patients who have non-insulin-dependent diabetes mellitus (Including Metformin: 60, Excluding Metformin: 60) and 60 patients as a control group were composed. The patient fasted at least 6 hours before receiving an intravenous injection of 370-592 MBq (10-16 mCi) of $^{18}F$-FDG. Scanning from the base of the skull though the mid thigh was performed using the Discovery STe PET/CT Equipment (GE Healthcare, Milwaukee, WI, USA). The highest uptake region was measured SUV among ascending, transverse and descending colon. Results: The values of patients who took the anti-diabetic drugs including Metformin were $6.16{\pm}3.64$ g/mL, $4.41{\pm}2.94$ g/mL, and $5.46{\pm}2.44$ g/mL. The patients who took the anti-diabetic drugs which does not have Metformin were $3.05{\pm}1.39$ g/mL, $2.08{\pm}0.97$ g/mL and $3.15{\pm}1.85$ g/mL. The control group were $2.02{\pm}0.88$ g/mL, $1.68{\pm}0.87$ g/mL and $2.19{\pm}1.88$ g/mL. Conclusion: The effect of the intake of Metformin was observed from the SUV on region of large bowel in this study. Thus, it could be helpful for the results by identifying the ingredient of anti-diabetic drug before the examination and the possibility of interpretation of false positive will be reduced.

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Ovarian and Endometrial $^{18}F$-FDG Uptake During the Menstrual Cycle in Normal Premenopausal Patients: Evaluation by PET/CT (월경주기에 따른 $^{18}F$-FDG PET/CT의 자궁 내 섭취에 관한 연구)

  • Bahn, Young-Kag;Park, Hoon-Hee;NamKoong, Hyuk;Kim, Sang-Kyoo;Lim, Han-Sang;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.43-47
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    • 2009
  • Purpose: The menstrual cycle of normal premenopausal patients was divide into menstrual flow phase, proliferative phase, ovulatory phase, secretory phase. The aim of this study was to ovarian and endometrial $^{18}F$-FDG uptake during the menstrual cycle in normal premenopausal patients. Materials and Methods: We identified 200 incidental $^{18}F$-FDG uptake in the ovary. The patient fasted at least 6 hours before receiving an intravenous injection of 370-592 MBq (10-16mCi) of $^{18}F$-FDG. Scanning from the base of the skull though the mid thigh was performed using the Discovery Ste PET/CT system (GE Healthcare, Milwaukee, WI, USA). Ovarian and endometrial $^{18}F$-FDG uptake (expressed as standardized uptake value) was measured on PET/CT image. Results: Two peaks of increased endometrial $^{18}F$-FDG uptake were identified during the menstrual cycle. The $SUV_{avg}$ and $SUV_{max}$ was $2.89{\pm}1.04$ and $3.17{\pm}1.59$ in menstruating patients, $2.4{\pm}0.88$ and $2.98{\pm}1.14$ in proliferative phase patients, $3.59{\pm}1.76$ and $3.17{\pm}1.67$ in ovulatory phase patients, $2.58{\pm}1.39$ and $3.1{\pm}1.8$ in secretory phase patients. Conclusions: Increased ovarian and endometrial $^{18}F$-FDG uptake could be found the time of menstrual flow and ovulatory phase of menstrual cycle. Increased uptake in endometrial adjacent to a cervical tumor does not necessarily reflect endometrial tumor invasion. Since increased uptake was dependent on the menstrual cycle, it can be avoided by scheduling PET/CT just after menstruation. Non-menstrual-related endometrial uptake may be instrumental in establishing a diagnosis in a premenopaual patient.

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Evaluation of Average CT to Reduce the Artifact in PET/CT (PET/CT 검사에서 호흡에 따른 인공산물을 줄이기 위한 Average CT의 유용성)

  • Kim, Jung-Sun;Nam, Ki-Pyo;Park, Seung-Yong;Ryu, Jae-Kwang;Cha, Min-Kyeong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.3-7
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    • 2010
  • Purpose: The usefulness of Positron Emission Tomography (PET) images in diagnosis, staging, recurrent and treatment response evaluation has already been known. However, tumors which are small size, located in lower lobe of lung or upper lobe of liver are shown misalignment, distortion and different Standard Uptake Value (SUV) by respiration in PET images. Therefore, if radiotherapy based on normal respiration, it may cause low treatment response or more side effects because targets which had to treat, out of treat range or over dose to normal tissue. The purpose of this study is to evaluate attenuation-correction with Average CT (ACT) for more accuracy SUV measurement and minimize artifact by respiration. Materials and Methods: 13 patients, who had tumors which are around the diaphragm, underwent ACT scan after Helical CT (HCT) scan with PET/CT (Discovery DSTE 8; GE Healthcare). We quantified the differences between attenuation corrected image with HCT and attenuation corrected image with ACT in artifact size and maximum SUV ($SUV_{max}$). Artifacts were evaluated by measurement of the curved photogenic area in the lower thorax of the PET images for all patients. $SUV_{max}$ was measured separately at the primary tumors. Analysis program was Advantage Workstation v4.3 (GE Healthcare). Patients were injected with 7.4 MBq (0.2 $mC_i$) per kg of $^{18}F$-FDG and scanned 1 hour after injection. The PET acquisition was 3 minute per bed. Results: Significantly lower artifact were observed in PET/ACT images than in PET/HCT images (below-thoracic artifacts caused by under corrected $1.5{\pm}3.5$ cm vs. $13.4{\pm}4.2$ cm). Significantly higher $SUV_{max}$ were noted in PET/ACT images than in PET/HCT images in the primary tumor. Compared with PET/HCT images, $SUV_{max}$ in PET/ACT images were higher by $5.3{\pm}3.9%$ (mean value) tumor. The highest difference was observed in Lower lobe of lung (7.7 to 8.7; 13%). Conclusion: Due to its significantly reduced artifacts in lower thoracic, attenuation corrected image with ACT images provided more reliable $SUV_{max}$ and may be helpful in monitoring treatment response. Moreover, ACT can separate upper lobe of liver and lower lobe of lung, it may be helpful in interpretation. ACT will be clinically useful, considering increased dose caused by ACT scan and adapt.

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An Analysis of Anomalous Radon Variation Caused by M5.8 Gyeong-ju Earthquake (규모 5.8 경주 지진에 의한 토양 내 라돈농도의 이상변화 분석)

  • Kim, Jin-seop;Kim, Minjun;Kim, Sunwoong;Lee, Hyomin
    • Economic and Environmental Geology
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    • v.51 no.1
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    • pp.1-13
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    • 2018
  • The radon concentration in soil varies with environmental factors such as atmospheric temperature and pressure, rainfall and soil temperature. The effects of these factors, therefore, should be differentiate in order to analyzed the anomalous radon variation caused by earthquake events. For these reasons, a comparative analysis between the radon variations with environmental factors and the anomalous variations caused by Gyeong-ju earthquake occurred in September 12, 2016 has been conducted. Radon concentration in soil and environmental factors were continuously measured at a monitoring ste located in 58Km away from earthquake epicenter from January 01, 2014 to May 31, 2017. The co-relationships between radon concentration and environmental factors were analyzed. The seasonal average radon concentration(n) and the standard variation(${\rho}$) was calculated, and the regions of ${\pm}1{\rho}$ and ${\pm}2{\rho}$ deviations from seasonal average concentration were investigated to find the anomalous radon variation related to Gyeong-ju earthquake. Earthquake effectiveness and q-factor were also calculated. The radon concentration indicated the seasonal variation pattern, showing high in summer and low in winter. It increases with increasing air temperature and soil temperature, and has the positive co-relationships of $R^2=0.9136$ and $R^2=0.8496$, respectively. The radon concentration decreases with increasing atmospheric pressure, and has the negative co-relationships of $R^2=0.7825$. Four regions of ${\pm}2{\rho}$ deviation from average seasonal concentration (A1: 7/3~7/5, A2: 7/18, A3: 8/4~8/5, A4: 10/17~10/20) were detected before and after Gyeong-ju earthquake. A1, A2, A3 were determined as the anomalous radon variation caused by the earthquake from co-relationship analyses with environmental factors, earthquake effectiveness and q-factor. During the period of anomalous radon variation, correlation coefficients between radon concentration and environmental factors were significantly lowered compared to other periods such as air temperature ($R^2=0.2314$), soil temperature ($R^2=0.1138$) and atmospheric pressure ($R^2=0.0475$). Annual average radon concentration was also highest at 2016, the year of Gyeong-ju earthquake.

Phytophagous Insect Fauna of Dicotyledoneae(Tracheophyta : Angiospermae) Weeds (쌍자엽 식물아강(관속식물문 : 피자식물강)의 잡초가해 곤충상)

  • ;;Patrick J.Shea
    • Korean journal of applied entomology
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    • v.31 no.4
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    • pp.496-508
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    • 1992
  • Phytophagous insects associated with Dicotyledoneae weeds and host specificities in the field populations were investigated for the survey of biological control agents of weeds in Korea. Fifty four weed species in 39 genera were collected during the survey. The most insects were collected from Polygonales by 24 species in 22 genera and followed by Urticales and Centrospermales by 17 species of 17 genera. The insects collected in the other weed orders were ranged from 1 to 12 species. Out of 17 insect species collected in Urticales, Baris sp. damaged the leaves of Hamulus japonicus in Cannabinaceae as scattered holeshape and showed host specificity. In Polygonaceae, Rumex japonicus and R. crispus were severely damaged by Aphis rumicis and Gastrophysa atrocyanea. G. atrocyanea leaf beetle had host specificity on R. japonicus and ate all the leaves except veins. The leaf beetle, Lypesthes japonicus was a potential biological control agent by feeding leaves of Persicaria spp .. And Lixus spp. were also often collected from Persicaria spp .. Liothrips vaneeckei was first collected from weed, P. modosa. P. senticosa was damaged by unidentified geometrid moth larvae and P. perfoiliata by Miarus atricolor snout beetle. Cassida piperata damaged leaves of Chenopodium album of Centrospermales and showed host specificity. In a soybean field, C. album and Amaranthus mangostanus were severely damaged by Spodoptera litura larvae which were eating soybean leaves. This phenomenon indicates that the presence of weed in cultivated land influences the outbreak of insect pests. Altica oleracea leaf beetle was frequently collected from Oenothera spp. of Onagraceae in Myrtales. Aphis gossyphi was outbroken on Solanum nigrum and Phylliodes brettinghami leaf beetle was first recorded on the same plant. Leaf beetles, Longitarsus scutellais and Hemipyxis plagioderoides were first collected from Plantago asiatica of Plantaginaceae in Plantaginales. They showed host specificities in the fields. The hemipterans were collected from many weeds during the survey and their roles on weeds should be investigated. A tractomorpha bedeli was also collected from many kinds of weeds in forest areas.

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Analysis of Patient Effective Dose in PET/CT; Using CT Dosimetry Programs (CT 선량 측정 프로그램을 이용한 PET/CT 검사 환자의 예측 유효 선량의 분석)

  • Kim, Jung-Sun;Jung, Woo-Young;Park, Seung-Yong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.77-82
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    • 2010
  • Purpose: As PET/CT come into wide use, it caused increasing of expose in clinical use. Therefore, Korea Food and Drug Administration issued Patient DRL (Diagnostic Reference Level) in CT scan. In this study, to build the basis of patient dose reduction, we analyzed effective dose in transmission scan with CT scan. Materials and Methods: From February, 2010 to March 180 patients (age: $55{\pm}16$, weight: $61.0{\pm}10.4$ kg) who examined $^{18}F$-FDG PET/CT in Asan Medical Center. Biograph Truepoint 40 (SIEMENS, GERMANY), Biograph Sensation 16 (SIEMENS, GERMANY) and Discovery STe8 (GE healthcare, USA) were used in this study. Per each male and female average of 30 patients doses were analyzed by one. Automatic exposure control system for controlling the dose can affect the largest by a patient's body weight less than 50 kg, 50-60 kg less, 60 kg more than the average of the three groups were divided doses. We compared that measured value of CT-expo v1.7 and ImPACT v1.0. The relationship between body weight and the effective dose were analyzed. Results: When using CT-Expo V1.7, effective dose with BIO40, BIO16 and DSTe8 respectably were $6.46{\pm}1.18$ mSv, $9.36{\pm}1.96 $mSv and $9.36{\pm}1.96$ mSv for 30 male patients respectably $6.29{\pm}0.97$ mSv, $10.02{\pm}2.42$ mSv and $9.05{\pm}2.27$ mSv for 30 female patients respectably. When using ImPACT v1.0, effective dose with BIO40, BIO16 and DSTe8 respectably were $6.54{\pm}1.21$ mSv, $8.36{\pm}1.69$ mSv and $9.74{\pm}2.55$Sv for 30 male patients respectably $5.87{\pm}1.09$ mSv, $8.43{\pm}1.89$ mSv and $9.19{\pm}2.29$ mSv for female patients respectably. When divided three groups which were under 50 kg, 50~60 kg and over 60 kg respectably were 6.27 mSv, 7.67 mSv and 9.33 mSv respectably using CT-Expo V1.7, 5.62 mSv, 7.22 mSv and 8.91 mSv respectably using ImPACT v1.0. Weight and the effective dose coefficient analysis showed a very strong positive correlation(r=743, r=0.693). Conclusion: Using such a dose evaluation programs, easier to predict and evaluate the effective dose possible without performing phantom study and such dose evaluation programs could be used to collect basic data for CT dose management.

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The Evaluation of SUV Variations According to the Errors of Entering Parameters in the PET-CT Examinations (PET/CT 검사에서 매개변수 입력오류에 따른 표준섭취계수 평가)

  • Kim, Jia;Hong, Gun Chul;Lee, Hyeok;Choi, Seong Wook
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.43-48
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    • 2014
  • Purpose: In the PET/CT images, The SUV (standardized uptake value) enables the quantitative assessment according to the biological changes of organs as the index of distinction whether lesion is malignant or not. Therefore, It is too important to enter parameters correctly that affect to the SUV. The purpose of this study is to evaluate an allowable error range of SUV as measuring the difference of results according to input errors of Activity, Weight, uptake Time among the parameters. Materials and Methods: Three inserts, Hot, Teflon and Air, were situated in the 1994 NEMA Phantom. Phantom was filled with 27.3 MBq/mL of 18F-FDG. The ratio of hotspot area activity to background area activity was regulated as 4:1. After scanning, Image was re-reconstructed after incurring input errors in Activity, Weight, uptake Time parameters as ${\pm}5%$, 10%, 15%, 30%, 50% from original data. ROIs (region of interests) were set one in the each insert areas and four in the background areas. $SUV_{mean}$ and percentage differences were calculated and compared in each areas. Results: $SUV_{mean}$ of Hot. Teflon, Air and BKG (Background) areas of original images were 4.5, 0.02. 0.1 and 1.0. The min and max value of $SUV_{mean}$ according to change of Activity error were 3.0 and 9.0 in Hot, 0.01 and 0.04 in Teflon, 0.1 and 0.3 in Air, 0.6 and 2.0 in BKG areas. And percentage differences were equally from -33% to 100%. In case of Weight error showed $SUV_{mean}$ as 2.2 and 6.7 in Hot, 0.01 and 0.03 in Tefron, 0.09 and 0.28 in Air, 0.5 and 1.5 in BKG areas. And percentage differences were equally from -50% to 50% except Teflon area's percentage deference that was from -50% to 52%. In case of uptake Time error showed $SUV_{mean}$ as 3.8 and 5.3 in Hot, 0.01 and 0.02 in Teflon, 0.1 and 0.2 in Air, 0.8 and 1.2 in BKG areas. And percentage differences were equally from 17% to -14% in Hot and BKG areas. Teflon area's percentage difference was from -50% to 52% and Air area's one was from -12% to 20%. Conclusion: As shown in the results, It was applied within ${\pm}5%$ of Activity and Weight errors if the allowable error range was configured within 5%. So, The calibration of dose calibrator and weighing machine has to conduct within ${\pm}5%$ error range because they can affect to Activity and Weight rates. In case of Time error, it showed separate error ranges according to the type of inserts. It showed within 5% error when Hot and BKG areas error were within ${\pm}15%$. So we have to consider each time errors if we use more than two clocks included scanner's one during the examinations.

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A Comparative Study of the Standard Uptake Values of the PET Reconstruction Methods; Using Contrast Enhanced CT and Non Contrast Enhanced CT (PET/CT 영상에서 조영제를 사용하지 않은 CT와 조영제를 사용한 CT를 이용한 감쇠보정에 따른 표준화섭취계수의 비교)

  • Lee, Seung-Jae;Park, Hoon-Hee;Ahn, Sha-Ron;Oh, Shin-Hyun;NamKoong, Heuk;Lim, Han-Sang;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.235-240
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    • 2008
  • Purpose: At the beginning of PET/CT, Computed Tomography was mainly used only for Attenuation Correction (AC), but as the performance of the CT have been increase, it could give improved diagnostic information with Contrast Media. But it was controversial that Contrast Media could affect AC on PET/CT scan. Some submitted thesis' show that Contrast Media could overestimate when it is for AC data processing. On the contrary, the opinion that Contrast Media could be possible to affect the alteration of SUV because of the overestimated AC. But it does not have a definite effect on the diagnosis. Thus, the affection of Contrast Media on AC was investigated in this study. Materials and Methods: Patient inclusion criteria required a history of a malignancy and performance of an integrated PET/CT scan and contrast- enhanced CT scan within a 1-day period. Thirty oncologic patients who had PET/CT scan from December 2007 to June 2008 underwent staging evaluation and met these criteria. All patients fasted for at least 6 hr before the IV injection of approximately 5.6 MBq/kg (0.15 mCi/kg) of $^{18}F$-FDG and were scanned about 60 min after injection. All patients had a whole body PET/CT performed without IV contrast media followed by a contrast-enhanced CT on the Discovery STe PET/CT scanner. CT data were used for AC and PET images came out after AC. The ROIs drew and measured SUV. A paired t-test of these results was performed to assess the significance of the difference between the SUV obtained from the two attenuation corrected PET images. Results: The mean and maximum Standardized Uptake Values (SUV) for different regions averaged over all Patients. Comparing before using Contrast Media and after using, Most of ROIs have the increased SUV when it did Contrast Enhanced CT compare to Non-Contrast enhanced CT. All regions have increased SUV and also their p value was under 0.05 except the mean SUV of the Heart region. Conclusion: In this regard, the effect on SUV measurements that occurs when a contrast-enhanced CT is used for attenuation correction could have significant clinical ramifications. But some submitted thesis insisted that the percentage change in SUV that can determine or modify clinical management of oncology patients is small. Because there was not much difference that could be discovered by interpreter. But obviously the numerical change was occurred and on the stage finding primary region, small change would be base line, such as the region of liver which has greater change than the other regions needs more attention.

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