Purpose: The whole body bone scan is an examination that visualizing physiological change of bones and using bone-congenial radiopharmaceutical. The patients are intravenous injected radiopharmaceutical which labeled with radioactive isotope ($^{99m}Tc$) emitting 140 keV gammarays and scanned after injection. The 3 principles of radiation protection from external exposureare time, distance and shielding. On the 3 principles of radiation protection basis, radiopharmaceutical might just as well be injected rapidly for reducing radiation because it might be the unopened radiation source. However the radiopharmaceuticals are injected into patient directly and there is a limitation of distance control. This study confirmed the change of radiation exposure as change of distance from radiopharmaceutical and observed the change of radiation exposure afte rsetting a shelter for help to control radio-technician's exposure. Materials & methods: For calculate the average of injection time, the trained injector measured the injection time for 50 times and calculated the average (2 minutes). We made a source as filled the 99mTc-HDP 925 MBq 0.2 mL in a 1 mL syringe and measured the radiation exposure from 50 cm,100 cm,150 cm and 200 cm by using Geiger-Mueller counter (FH-40, Thermo Scientific, USA). Then we settled a lead shielding (lead equivalent 6 mm) from the source 25 cm distance and measured the radiation exposure from 50 cm distance. For verify the reproducibility, the measurement was done among 20 times. The correlation between before and after shielding was verified by using SPSS (ver. 18) as paired t-test. Results: The radiation doses according to distance during 2 minutes from the source without shielding were $1.986{\pm}0.052{\mu}$ Sv in 50 cm, $0.515{\pm}0.022{\mu}$ Sv in 100 cm, $0.251{\pm}0.012{\mu}$ Sv in 150 cm, $0.148{\pm}0.006{\mu}$ Sv in 200 cm. After setting the shielding, the radiation dose was $0.035{\pm}0.003{\mu}$ Sv. Therefore, there was a statistical significant difference between the radiation doses with shielding and without shielding ($p$<0.001). Conclusion: Because the great importance of whole body bone scan in the nuclear medicine, we should make an effort to reduce radiation exposure during radiopharmaceutical injections by referring the principles of radiation protection from external exposure. However there is a limitation of distance for direct injection and time for patients having attenuated tubules. We confirmed the reduction of radiation exposure by increasing distance. In case of setting shield from source 25 cm away, we confirmed reducing of radiation exposure. Therefore it would be better for reducing of radiation exposure to using shield during radiopharmaceutical injection.
Purpose: Most of diagnosis in the pediatric hydronephrosis patients have been performed $^{99m}Tc$-DMSA renal scan. Then the region of interest (ROI) is set for comparative analysis of uptake ratio in left-right kidney after acquiring the image. But if the equipment set an automatic ROI, the ROI could include expanded renal pelvis due to hydronephrosis and the uptake ratio of left-right kidney will be incorrect result. Therefore this study compared both ROIs including expanded renal pelvis and excluding renal pelvis through experiment using normal kidney phantom and expanded renal pelvis phantom and suggested setting method of improved ROI. In addition, this study have been helped by readout doctor for investigate distinction radiopharmaceutical uptake between renal cortex and remained urine by expanded renal pelvis. Materials and Methods: The both of renal phantoms were filled with water and shacked with $^{99m}TcO_4$ 111 MBq. In order to describe the expanded renal pelvis, the five latex balloon were all filled with 10 mL water and each of balloon was mixed with $^{99m}TcO_4$ 18.5, 37, 55.5, 74, 92.5 MBq. And we made phantom with fixed $^{99m}TcO_4$activity of 37 MBq and mixed water 5, 10, 15, 20, 25 mL in each balloon. The left kidney was fixed its shape and the right kidney was modified like as hydronephrosis kidney by attached the latex balloons. And the acquiring counts were 2 million. After acquisition, we compared the image of ROI with Expanded renal pelvis and the image of ROI without renal pelvis for analyzing difference in the uptake ratio of left-right kidney and for reproducibility, set the ROI 5 times in the same images. Patients were injected $^{99m}Tc$-DMSA 1.5~1.9 MBq/kg and scanned 3 to 4 hours after injection. The each of 3 skillful radio technologists performed the comparing estimation by setting ROI. To determine statistical significance between two data, SPSS (ver. 17) Wilcoxon Signed Ranks Test was used. Results: As a result of renal phantom's experiment, we compared with average of counts Background (BKG) ratios in the setting of ROI including expanded renal pelvis and setting of excluding expanded renal pelvis. Therefore, they can obtain changed counts and changed ratios. Patient also can obtain same results. In addition, the radiopharmaceutical uptake in expanded renal pelvis was come out the remained urine that couldn't descend to ureter by the help of readout doctor. Conclusion: As above results, the case of setting ROI including expanded renal pelvis was more abnormally increasing uptake ratio than the case of setting ROI excluding expanded renal pelvis in analysis the uptake ratio in left-right kidney of hydronephrosis. Because of the work convenience and prompted analysis, the automatic ROI is generally used. But in case of the hydronephrosis study, we should set the manual ROI without expanded renal pelvis for an accurate observation of the uptake ratio of left-right kidney since the radiopharmaceutical uptake in expanded renal pelvis is the remained urine.
Purpose: Radioiodine (I-131) therapy is an effective modality to reduce both recurrence and mortality rates in differentiated thyroid cancer. Whether higher doses shows higher therapeutic responses was still debatable. The purpose of this study was to validate curve-fitting (CF) method measuring maximum permissible dose (MPD) by a biological dosimetry using metaphase analysis of peripheral blood lymphocytes. Materials and Methods: Therapeutic effects of MPD was evaluated in 58 patients (49 females and 9 males, mean age $50{\pm}11$ years) of papillary thyroid cancer. Among them 43 patients were treated with ${\Leq}7.4GBq$, while 15 patients with ${\geq}9.25GBq$. The former was defined as low-dose group, and the latter high-dose group. Therapeutic response was defined as complete response when complete disappearance of lesions on follow-up I-131 scan and undetectable serum thyroglobulin levels were found. Statistical comparison between groups were done using chi-square test. P value less than 0.05 was regarded as statistically significant. Results: MPD measured by CF method using tracer and therapeutic doses were $13.3{\pm}1.9\;and\;13.8{\pm}2.1GBq$, respectively (p=0.20). They showed a significant correlation (r=0.8, p<0.0001). Exposed doses to blood measured by CF and biological methods were $1.54{\pm}0.03\;and\;1.78{\pm}0.03Gy$ (p=0.01). They also showed a significant correlation (r=0.86, p=0.01). High-dose group showed a significantly higher rate of complete response (12/15, 80%) as compared to the low-dose group (22/43, 51.2%) (p=0.05). While occurrence of side effects was not different between two groups (40% vs. 30.2%, p=0.46). Conclusion: Measurement of MPD using CF method is reliable, and the high-dose I-131 therapy using MPD gains significantly higher therapeutic effects as compared with low-dose therapy.
Purpose: The limited FOV(Field of View) of CT (Computed Tomography) can cause truncation artifact at external DFOV (Display Field of View) in PET/CT image. In our study, we measured the difference of SUV and compared the influence affecting to the image reconstructed with the extended DFOV. Materials and Methods: NEMA 1994 PET Phantom was filled with $^{18}F$(FDG) of 5.3 kBq/mL and placed at the center of FOV. Phantom images were acquired through emission scan. Shift the phantom's location to the external edge of DFOV and images were acquired with same method. All of acquired data through each experiment were reconstructed with same method, DFOV was applied 50 cm and 70 cm respectively. Then ROI was set up on the emission image, performed the comparative analysis SUV. In the clinical test, patient group shown truncation artifact was selected. ROI was set up at the liver of patient's image and performed the comparative analysis SUV according to the change of DFOV. Results: The pixel size was increase from 3.91 mm to 5.47 mm according to the DFOV increment in the centered location phantom study. When extended DFOV was applied, $_{max}SUV$ of ROI was decreased from 1.49 to 1.35. In case of shifted the center of phantom location study, $_{max}SUV$ was decreased from 1.30 to 1.20. The $_{max}SUV$ was 1.51 at the truncated region in the extended DFOV. The difference of the $_{max}SUV$ was 25.9% higher at the outside of the truncated region than inside. When the extended DFOV was applied, $_{max}SUV$ was decreased from 3.38 to 3.13. Conclusion: When the extended DFOV was applied, $_{max}SUV$ decreasing phenomenon can cause pixel to pixel noise by increasing of pixel size. In this reason, $_{max}SUV$ was underestimated. Therefore, We should consider the underestimation of quantitative result in the whole image plane in case of patient study applied extended DFOV protocol. Consequently, the result of the quantitative analysis may show more higher than inside at the truncated region.
MRI scan is a useful method in the diagnosis of musculoskeletal excellent contrast of the organization. Depending on the patient's musculoskeletal examinations state the type of aids provided the aid is used there is also challenging as well as the costs do not vary. This study was produced by the use of 3D printing technology, an MRI aids. Aids in the production process, then through 3D modeling and then convert stl files using (3D MAX.2014, Fusion360) slicing programs (Cubicreater 2.1ver., Cura 15.4ver) converted to G-code printed on the FDM scheme (Cubicon Style, output was MICRO MAKE). Output is, but in the FDM to evaluate the SNR on the MRI images were compared to the test is the case before use, and then to produce a Water Phantom case of a PLA, ABS, a TPU thickness 3mm, using aids before, It was evaluated in a clinical image after qualitatively. Obtaining an image of SNR Warter Phantom appeared to have been evaluated as T1 NON $123.778{\pm}28.492$, PLA $123.522{\pm}28.373$, ABS $124.461{\pm}25.716$, TPU $124.843{\pm}27.272$. T2 NON $127.421{\pm}26.949$, was rated as PLA $124.501{\pm}27.768$, ABS $128.663{\pm}26.549$, TPU $130.171{\pm}25.998$. The results did not show statistically significant differences. The use of assistive devices before and after images Clinical evaluation method palliative $3.20{\pm}0.88$, $3.95{\pm}0.76$ after using the aids used to aid improved the quality of the image. Production of the auxiliary mechanism using a future 3D printing is expected are thought to be used clinically, it can be an aid making safe and comfortable than the inspection of the patient is an alternative to improve the problems of the aids used in the conventional do.
Park, Myung-Hwan;Lee, Jin-Wan;Lee, Kang-Won;Ryu, Chang-Woo;Jahng, Geon-Ho
Investigative Magnetic Resonance Imaging
/
v.13
no.2
/
pp.161-170
/
2009
Purpose : A parallel imaging method provides us to improve temporal resolution to obtain three-dimensional (3D) MR images. The objective of this study was to optimize three 3D MRI techniques by adjusting 2D SESNE factors of the parallel imaging method in phantom and human brain. Materials and Methods : With a 3 Tesla MRI system and an 8-channel phase-array sensitivity-encoding (SENSE) coil, three 3D MRI techniques of 3D T1-weighted imaging (3D T1WI), 3D T2-weighted imaging (3D T2WI) and 3D fluid attenuated inversion recovery (3D FLAIR) imaging were optimized with adjusting SESNE factors in a water phantom and three human brains. The 2D SENSE factor was applied on the phase-encoding and the slice-encoding directions. Signal-to-noise ratio(SNR), percent signal reduction rate(%R), and contrast-to-noise ratio(CNR) were calculated by using signal intensities obtained in specific regions-of-interest (ROI). Results : In the phantom study, SENSE factor = 3 was provided in 0.2% reduction of signals against without using SENSE with imaging within 5 minutes for 3D T1WI. SENSE factor = 2 was provided in 0.98% signal reduction against without using SENSE with imaging within 5 minutes for 3D T2WI. SENSE factor = 4 was provided in 0.2% signal reduction against without using SENSE with imaging around 6 minutes for 3D FLAIR. In the human brain study, SNR and CNR were higher with SENSE factors = 3 than 4 for all three imaging techniques. Conclusion : This study was performed to optimize 2D SENSE factors in the three 3D MRI techniques that can be scanned in clinical time limitations with minimizing SNR reductions. Without compromising SNR and CNR, the optimum 2D SENSE factors were 3 and 4, yielding the scan time of about 5 to 6 minutes. Further studies are necessary to optimize 3D MRI techniques in other areas in human body.
Purpose The purpose of this study was to evaluate image quality change by truncated region in field of view (FOV) of attenuation correction computed tomography (AC-CT) in brain PET/CT. Materials and Methods Biograph Truepoint 40 with TrueV (Siemens) was used as a scanner. $^{68}Ge$ phantom scan was performed with and without applying brain holder using brain PET/CT protocol. PET attenuation correction factor (ACF) was evaluated according to existence of pallet in FOV of AC-CT. FBP, OSEM-3D and PSF methods were applied for PET reconstruction. Parameters of iteration 4, subsets 21 and gaussian 2 mm filter were applied for iterative reconstruction methods. Window level 2900, width 6000 and level 4, 200, width 1000 were set for visual evaluation of PET AC images. Vertical profiles of 5 slices and 20 slices summation images applied gaussian 5 mm filter were produced for evaluating integral uniformity. Results Patient pallet was not covered in FOV of AC-CT when without applying brain holder because of small size of FOV. It resulted in defect of ACF sinogram by truncated region in ACF evaluation. When without applying brain holder, defect was appeared in lower part of transverse image on condition of window level 4200, width 1000 in PET AC image evaluation. With and without applying brain holder, integral uniformities of 5 slices and 20 slices summation images were 7.2%, 6.7% and 11.7%, 6.7%. Conclusion Truncated region by small FOV results in count defect in occipital lobe of brain in clinical or research studies. It is necessary to understand effect of truncated region and apply appropriate accessory for brain PET/CT.
Kim, Jung-Yul;Kang, Chun-Koo;Park, Hoon-Hee;Lim, Han-Sang;Lee, Chang-Ho
The Korean Journal of Nuclear Medicine Technology
/
v.16
no.1
/
pp.12-16
/
2012
Purpose : In conventional PET image reconstruction, iterative reconstruction methods such as OSEM (Ordered Subsets Expectation Maximization) have now generally replaced traditional analytic methods such as filtered back-projection. This includes improvements in components of the system model geometry, fully 3D scatter and low noise randoms estimates. SharpIR algorithm is to improve PET image contrast to noise by incorporating information about the PET detector response into the 3D iterative reconstruction algorithm. The aim of this study is evaluation of SharpIR reconstruction method in PET/CT. Materials and Methods: For the measurement of detector response for the spatial resolution, a capillary tube was filled with FDG and scanned at varying distances from the iso-center (5, 10, 15, 20 cm). To measure image quality for contrast recovery, the NEMA IEC body phantom (Data Spectrum Corporation, Hillsborough, NC) with diameters of 1, 13, 17 and 22 for simulating hot and 28 and 37 mm for simulating cold lesions. A solution of 5.4 kBq/mL of $^{18}F$-FDG in water was used as a radioactive background obtaining a lesion of background ratio of 4.0. Images were reconstructed with VUE point HD and VUE point HD using SharpIR reconstruction algorithm. For the clinical evaluation, a whole body FDG scan acquired and to demonstrate contrast recovery, ROIs were drawn on a metabolic hot spot and also on a uniform region of the liver. Images were reconstructed with function of varying iteration number (1~10). Results: The result of increases axial distance from iso-center, full width at half maximum (FWHM) is also increasing in VUE point HD reconstruction image. Even showed an increasing distances constant FWHM. VUE point HD with SharpIR than VUE point HD showed improves contrast recovery in phantom and clinical study. Conclusion: By incorporating more information about the detector system response, the SharpIR algorithm improves the accuracy of underlying model used in VUE point HD. SharpIR algorithm improve spatial resolution for a line source in air, and improves contrast recovery at equivalent noise levels in phantoms and clinical studies. Therefore, SharpIR algorithm can be applied as through a longitudinal study will be useful in clinical.
This study is aimed to evaluate the effect of $T_{1/2}$ upon count rates in the analysis of dynamic scan using NaI (Tl) scintillation camera, and suggest a new quality control method with this effects. We producted a point source with $^{99m}TcO_4^-$ of 18.5 to 185 MBq in the 2 mL syringes, and acquired 30 frames of dynamic images with 10 to 60 seconds each using Infinia gamma camera (GE, USA). In the second experiment, 90 frames of dynamic images were acquired from 74 MBq point source by 5 gamma cameras (Infinia 2, Forte 2, Argus 1). There were not significant differences in average count rates of the sources with 18.5 to 92.5 MBq in the analysis of 10 to 60 seconds/frame with 10 seconds interval in the first experiment (p>0.05). But there were significantly low average count rates with the sources over 111 MBq activity at 60 seconds/frame (p<0.01). According to the second analysis results of linear regression by count rates of 5 gamma cameras those were acquired during 90 minutes, counting efficiency of fourth gamma camera was most low as 0.0064%, and gradient and coefficient of variation was high as 0.0042 and 0.229 each. We could not find abnormal fluctuation in $x^2$ test with count rates (p>0.02), and we could find the homogeneity of variance in Levene's F-test among the gamma cameras (p>0.05). At the correlation analysis, there was only correlation between counting efficiency and gradient as significant negative correlation (r=-0.90, p<0.05). Lastly, according to the results of calculation of $T_{1/2}$ error from change of gradient with -0.25% to +0.25%, if $T_{1/2}$ is relatively long, or gradient is high, the error increase relationally. When estimate the value of 4th camera which has highest gradient from the above mentioned result, we could not see $T_{1/2}$ error within 60 minutes at that value. In conclusion, it is necessary for the scintillation gamma camera in medical field to manage hard for the quality of radiation measurement. Especially, we found a tendency that count rate changes over time at this study, and we proved that it can effect $T_{1/2}$. And also, there is need of appropriate phantoms and the method of quality management like this study, because there are not any advice or limitation degrees for domestic medical purpose scintillation camera.
Song Seung-Hwan;Jun Tae-Gook;Lee Young-Tak;Sung Ki-Ick;Yang Ji-Hyuk;Choi Jin-Ho;Kim Jin-Sun;Kim Ho-Joong;Park Pyo-Won
Journal of Chest Surgery
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v.39
no.8
s.265
/
pp.626-632
/
2006
Background: Pulmonary hypertension caused by chronic pulmonary embolism is underrecognized and carries a poor prognosis. Medical therapy is generally unsatisfactory and palliative. With the improvement of operative technique and postoperative management, pulmonary endarterectomy has been the treatment of choice for this condition. Material and Method: Between January 2001 and December 2005, eleven patients were received pulmonary endarterectomy. All patients had chronic dyspnea and exercise intolerance. Diagnosis was made with cardiac echocardiography, lung perfusion scan and computed tomography. Before the operation, Greenfield vena cava filter were placed in all patient except one. Deep hypothermic circulatory arrest was used for the distal-most portion of the endarterectomy procedure. More than moderate degree of tricuspid reguirgitation was repaired during operation. Result: There was no early and late death. Right ventricular systolic pressure was reduced significantly after operation from $91{\pm}21$ mmHg to $40{\pm}17$ mmHg on echocardiography (p=0.001). NYHA class and tricuspid reguirgitaion were improved postoperatively. Although mild reperfusion injury in three case and postoperative delirium in one case were observed, all of them recovered without complication. Conclusion: Pulmonary thromboendarterctomy offers to patient an acceptable morbidity rate and anticipation of clinical improvement. This method is safe and effective operation for pulmonary hypertension caused by chronic pulmonary thromboembolism.
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