• Title/Summary/Keyword: Single-photon emission computed tomography

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Clinical Significance of Reverse Redistribution Phenomenon on Delayed Tc-99m Tetrofosmin Myocardial Perfusion Imaging in Patients with Acute Myocardial Infarction (급성 심근경색 환자의 Tc-99m Tetrofosmin 심근 관류 지연영상에서 관찰되는 역재분포 현상의 임상적 의의)

  • Park, Soon-Ah;Kim, Dae-Weung;Kim, Chang-Guhn;Jeong, Jin-Won;Kim, Nam-Ho;Yun, Kyeong-Ho
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.112-119
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    • 2009
  • Purpose: This study was performed to investigate the clinical significance of reverse redistribution(RR) phenomenon detected on delayed Tc-99m tetrofosmin myocardial single photon emission computed tomography(SPEG) in patients with acute myocardial infarction after revascularization. Materials and Methods: A Tc-99m tetrofrosmin myocardial SPECT was performed in 67 consecutive patients after revascularization for acute myocardial infarction. Myocardial SPECT imaging was performed for early imaging at 40 min and for delayed imaging at 180 min after reinjection at myocardial stress. Regional myocardial uptakes were scored by 4-point scoring in the left ventricular wall divided into 17 segments. Reverse redistribution was defined as an increase of more than 2 point in the activity score on the delayed image. Follow-up myocardial SPECT and coronary angiography(CAG) were performed 9 months later. Results: On myocardial SPECT performed following revascularization, RR was observed in 100 of all 319 segments(31%) and in 43 patients(64%). The abnormalities of perfusion and regional wall motion were more severe in the patients with RR compared to those without RR(p<0.05). On follow-up myocardial SPECT, the myocardial perfusion, regional wall motion, and myocardial thickness were significantly improved in the patients with RR(p<0.05) however, these changes were not significant in those without RR. There was no significant difference between the patients with RR and those without RR in the occurrence of restenosis on CAG. Conclusions: In patients with acute myocardial infarction, the regions showing the RR phenomenon on delayed Tc-99m tetrofosmin SPECT may reflect viable myocardium and indicate recovery of salvaged myocardium.

Clinical Usefulness of 99mTc-DMSA Renal SPECT Using High Sensitivity-All Purpose Collimator for Pediatric Patients (고감도 범용성 콜리메이터를 이용한 소아 환자 99mTc-DMSA 신장 SPECT의 유용성)

  • Kim, Jin-Eui;Kim, Jung-Soo;Han, Jae-Bok;Choi, Nam-Gil
    • The Journal of the Korea Contents Association
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    • v.16 no.3
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    • pp.219-231
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    • 2016
  • $^{99m}Tc$-DMSA planar scan that can analyze the functions of kidney quantitatively provides less information on a lesion than tomography scanning. Therefore, this study applied a high sensitivity all-purpose collimator that is sensitive to photonic signals to $^{99m}Tc$-DMSA and carried out a clinical scan with single photon emission computed tomography (SPECT). And diagnostic accuracy and time requirement of were analyzed to know the clinical usefulness of the applied scanning method. 10 subjects were intravenously injected with radiopharmaceutical product (1.0-1.2 MBq/kg) and scanned by a gamma camera with planar scanner (high resolution (HR)-mode, $256{\times}256$, 50 kcts/view, 4 image) and SPECT (HR / high sensitive (HS)-mode, $128{\times}128$, step and shoot, $180^{\circ}$, variable sec/angle, total 64 frame, OSEM reconstruction), respectively. The collected data was compared with an analysis program. The results showed that HS-mode SPECT detected total counts 1.8-5.6 times more than planar scan. Relative renal function evaluated based on the counts was not significantly different by two scanning methods (p=0.96) and it turned out that test time was shortened by 39% when HS-mode SPECT was used. Therefore, SPECT using HR, HS-mode collimator could analyze renal function more quantitatively than using planar scan and the former could diagnose the location information of a lesion more accurately than the latter as well as shortened test time requirement, which demonstrated the clinical usefulness of $^{99m}Tc$-DMSA renal SPECT using high sensitivity all purpose collimator.

Assessment of Cerebral Collateral Circulation Using $^{99m}Tc$-Hexamethyleneamine Oxime (HMPAO) SPECT During Internal Carotid Artery Balloon Test Occlusion (내경동맥 풍선 시험 결찰술(BTO)시 $^{99m}Tc$-HMPAO 뇌 SPECT를 이용한 대뇌 측부 순환의 평가)

  • Ryu, Young-Hoon;Yun, Mi-Jin;Chung, Tae-Sub;Lee, Jong-Doo;Park, Chang-Yun
    • The Korean Journal of Nuclear Medicine
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    • v.29 no.1
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    • pp.22-30
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    • 1995
  • To predict preoperatively the safety of permanent occlusion of an internal carotid artery with $^{99m}Tc$-HMPAO brain single photon emission computed tomography(SPECT) from an objective point of view, Twenty-four patients underwent balloon test occlusion (BTO) of the internal carotid arteries because of neck and skull base tumors. The authors assessed the uptake of both middle cerebral artery territories before and during BTO with $^{99m}Tc$-HMPAO brain SPECT using semiquantitative analysis method and compared the results with other factors(neurologic examination, arterial stump pressure and electroenceph-alogram). Nineteen patients had not experienced neurological deteriorating or any problem during BTO. Their comparative uptakes of the middle cerebral artery territories were 95 to 101% of the pre-BTO state. The remaining five patients showed severe neurologic symptoms such as transient hemiplegia and unconsciousness. Their comparative uptake of the middle cerebral artery territories were 77 to 85% of the pre-BTO state, and were well matched with other factors. $^{99m}Tc$-HMPAO brain SPECT before and during BTO seems to be a simple and objective method for prediction of permanent neurologic deficits when the comparative uptake of middle cerebral artery territories during BTO is lower than 85% of that before BTO.

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The comparisons of three scatter correction methods using Monte Carlo simulation (몬테카를로 시뮬레이션을 이용한 산란보정 방법들에 대한 비교)

  • 봉정균;김희중;이종두;권수일
    • Progress in Medical Physics
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    • v.10 no.2
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    • pp.73-81
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    • 1999
  • Scatter correction for single photon emission computed tomography (SPECT) plays an important role to improve image quality and quantitation. The purpose of this study was to investigate three scatter correction methods using Monte Carlo simulation. Point source and Jaszack phantom filled with Tc-99m were simulated by Monte Carlo code, SIMIND. For scatter correction, we applied three methods, Compton window (CW) method, triple window (TW) method, and dual photopeak window (DPW) method. Point sources located at various depths along the center line within a 20-cm phantom were simulated to calculate the window ratios and corresponding scatter fractions by evaluating the polynomial coefficients for DPW method. Energy windows were located in W$_1$=92-125 keV, W$_2$=124-126 keV, W$_3$=136-140 keV, W$_4$=140-141 keV, and W$_{5}$=154-156 keV. The results showed that in Jaszack phantom with cold sphere and hot sphere, the TW gave the closest contrast and percentage recovery to the ideal image, respectively, while CW overestimated and DPW underestimated the contrast of ideal one. All three scatter correction methods showed an improved image contrast. In conclusion, scatter correction is essential for improving image contrast and accurate quantification. The choice of scatter correction method should be made on the basis of accuracies and ease of implementation.

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Compared Performance of Semiconductor SPECT in Myocardial Perfusion SPECT: Phantom study (범용 신틸레이터 감마카메라와 심근전용 반도체 감마카메라의 성능 비교 연구)

  • Bahn, Young Kag;Hwang, Dong Hoon;Kim, Jung Yul;Kang, Chun Koo;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.49-53
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    • 2016
  • Purpose Recently, Cadmium-zinc-telluride (CZT) semiconductor myocardial SPECT (Single Photon Emission Computed Tomography) has been used myocardial scintigraphy. In this study, the performance of Semiconductor SPECT and conventional SPECT systems was compared by a comprehensive analysis of phantom SPECT images. Materials and Methods Methods: We evaluated the DSPECT CZT SEPCT (Spectrum-dynamic) and INFINA conventional (GE). Physical performance was compared on reconstructed SPECT images from a phantom. Results For count sensitivity on cardiac phantom images ($counts{\cdot}sec^{-1}{\cdot}MBq^{-1}$), DSPECT had a sensitivity of conventional SPECT. This classification was similar to that of myocardial counts normalized to injected activities from phantom images (respective mean values, $counts{\cdot}sec^{-1}{\cdot}MBq^{-1}$: 195.83 and 52.83). For central spatial resolution: DSPECT, 9.47mm; conventional SPECT, 16.90mm. For contrast-to-noise ratio on the phantom: DSPECT, 4.2; conventional SPECT, 3.6. Conclusion The performance of CZT cameras is dramatically higher than that of conventional SPECT. However, CZT cameras differ in that spatial resolution and contrast-to-noise ratio are better with conventional SPECT, whereas count sensitivity is markedly higher with the DSPECT.

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Venous Congestion in Cerebral Hyperperfusion Syndrome: A Case Report (뇌과관류증후군에서 보일 수 있는 정맥울혈 1례)

  • Bong, Jeong Bin;Kang, Hyun Goo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.8
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    • pp.84-87
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    • 2017
  • Cerebral hyperperfusion syndrome (CHS) is a rare complication that can occur when conducting stent insertion or endarterectomy in patients with carotid artery stenosis and is known to be caused by various mechanisms when the blood volume abruptly increases. The main clinical symptoms are unilateral headache, hypertension, seizure, and focal neurologic deficit. Subarachnoid hemorrhage and parenchymal hemorrhage may lead to permanent impairment or death in severe cases. CHS can be predicted by using transcranial Doppler, perfusion magnetic resonance imaging, and single photon emission computed tomography. In our case report, a patient developed CHS subsequent to significant venous congestion caused by carotid artery stent insertion. The patient had preexisting, symptomatic bilateral carotid artery stenosis. Venous congestion occurs when the direction of blood flow changes because of increased blood volume in patients with well-developed collateral vessels. We believe that CHS can be predicted from this finding. This study reports the possibility that CHS could be confirmed by cerebral angiography after insertion of the internal carotid stent.

Association between Cerebral Blood Flow and Cognitive Improvement Effect by B. mori Extracted Component (가잠 가수분해물에 의한 학습력 개선 및 두뇌의 혈류변화와 글루코스 사용정도의 긍정적 변화)

  • Lee, Sang-Hyung;Kim, Yong-Sik;Kim, Sung-Su;Kang, Yong-Koo;Lee, Moo-Yeol;Lee, Kwang-Gill;Yeo, Joo-Hong;Lee, Won-Bok;Kim, Dae-Kyong
    • Journal of Sericultural and Entomological Science
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    • v.46 no.2
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    • pp.77-79
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    • 2004
  • To investigate whether BF-7, extracted from Bombyx mori, improved learning and memory of ordinary people, K-WAIS (Korean version of Wechsler adult intelligence scale) was performed in 4 normal students. Treatment with 400 mg of BF-7 increased mean IQ from 103 to 114. To know how BF-7 plays such a positive role, we measured the blood flow to brain, especially for the area concerned with learning and memory, with Single Photon Emission Computed Tomography(SPECT). Our result showed that the blood flow to parahippocampal gyrus and medial temporal area was increased. Also, our results showed the image representing the increase of blood supply in this area. So, our results suggest that BF-7 effectively help to use brain concerning with learning and memory.

Regional Cerebral Perfusion Abnormalities in Autistic Disorder : Statistical Parametric Mapping Analysis (자폐 장애에서의 국소 대뇌관류 이상)

  • Kim, Su-Jin;Kim, Boong-Nyun;Cho, Soo-Churl;Kang, Je-Wook;Kim, Jae-Won;Shin, Min-Sup;Cheong, Kwang-Mo;Kim, Hyo-Won
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.20 no.3
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    • pp.122-128
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    • 2009
  • Objectives : Autism is a well-known psychiatric disorder that is presumed to have a neural basis. To investigate the underlying neurofunctional abnormalities of autism, the authors performed single photon emission computed tomography (SPECT) on children with autism. Methods : Fifty-five children with untreated autism (47 boys and 8 girls, mean age=$50.6{\pm}20.28$ months) were selected from among the patients visiting the child and adolescent psychiatric clinic of Seoul National University Hospital. Psychiatrists had diagnosed the participants according to the DSM-IV criteria for autistic disorder and the Childhood Autism Rating Scale (CARS) criteria for a diagnosis of autism. All participants were examined using 99mTC-HMPAO Brain SPECT. Using statistical parametric mapping (SPM) analysis, we compared the participants' SPECT images to standardized SPECT images of normal children, which had been retrospectively selected by the authors, on a voxel by voxel basis. Voxels with a p-value less than .001 were considered to be significantly different. Results : The autistic group showed significant hypoperfusion in the right medial frontal gyrus, right precentral gyrus, and left precuneus gyrus. In addition, they showed no significant hyperperfusion areas when compared to the control group. Conclusion : The findings of hypoperfusion in the medial-frontal lobe and precuneus are accord with hemodynamic abnormalities that have been already reported. Therefore, these findings are compatible with the recently suggested "theory of mind" hypothesis and the disturbances in attention shifting that have been observed in autistic children.

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The change of CBF(cerebral blood flow) of CVA patients by oriental medical treatment - Focused on Brain SPECT results - (뇌졸중환자(腦卒中患者)에 있어서 치료경과(治療經過)에 따른 뇌혈류(腦血流) 변화(變化) - Brain SPECT 결과(結果)를 중심(中心)으로 -)

  • Kang, Hwa-Jeong;Hong, Seok;Kim, Jong-Seok;Song, Ho-Chon;Bum, Hee-Seung;Jeon, Sang-Yun
    • The Journal of Internal Korean Medicine
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    • v.21 no.1
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    • pp.39-45
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    • 2000
  • Object : SPECT which can visualize the distribution of CBF was operated to find the basic evidence by objective and scientific inspection on the fact that how the oriental medical treatment for stroke patients can effect CBF. Method : This study made 18 cases an object of research. These patients came to the Dongshin Univ. Oriental Medical Hospical within 5 days from the first attack, were diagnosed as stroke from Brain CT and MAl and were in the hospital for over 4 weeks at least. They were taken acupunture treatment, negative technique and herbal medication. And this study operated SPECT at the instance of admission and at the 4th week after admission 2 times and compared the change of CBF. Results : I operated SPECT on 18 CVA patients and got a result on the change of blood supplies in brain as follows; In the 2nd SPECT compared with 1st, out of the 1st and 2nd SPECT, there are 10 cases(55.6%) of increase and 8 cases (44.4%) of decrease. According to L/Cb11 evauation standard, the 1 st and the 2nd changes of blood supplies in SPECT shows decrese from $0.830{\pm}0.071$ to $0.801{\pm}0.067$. On the other hand, according to L/C standard shows a minute increase from $0.894{\pm}0.079$ to $0.895{\pm}0.091$. But there is nothing meaningful. I treated patients' group with risk factors and the other patients' group without risk factors and observed the changes of blood supplies respectively. And therefore Patients' group without risk factors shows an meaningful increase of blood supplies from $0.835{\pm}0.076$ to $0.796{\pm}0.069$ L/Cbll and also an increase from $0.921{\pm}0.029$ to $0.939{\pm}0.029$ by L/C. But this result by L/C is not significant. Conclusion : As mentioned above, I treated CVA patients through oriental medical therapies using SPECT and researched the changes of blood supplies in their brains. But I could' t get any meaningful result. However, I think only after solving some problems in this treatment and quantifing the changes of blood supplies, this results can be the standard of scientific examination about oriental medical treatments.

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Quantitative Assessment of Myocardial Infarction by In-111 Antimyosin Antibody (In-111-Antimyosin 항체를 이용한 심근경색의 정량적 평가)

  • Lee, Myung-Chul;Lee, Kyung-Han;Choi, Yoon-Ho;Chung, June-Key;Park, Young-Bae;Koh, Chang-Soon;Moon, Dae-Hyuk
    • The Korean Journal of Nuclear Medicine
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    • v.25 no.1
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    • pp.37-45
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    • 1991
  • Infarct size is a major determinant of prognosis after acute myocardial infarction. Up to date, however, clinically available tests to estimate this size have not been sufficiently accurate. Twelve lead electrocardiogram and wall motion abnormality measurement are not quantitative, and creatine phophokinase (CPK) measurement is inaccurate in the presence of reperfusion or right ventricular infarction. Methods have been developed to localize and size acute myocardial infarcts with agents that are selectively sequestered in areas of myocardial damage, but previously used agents have lacked sufficient specificity. Antibodies that bind specifically only to damaged myocardial cells may resolve this problem and provide an accurate method for noninvasively measuring infarct size. We determined the accuracy with which infarcted myocardial mass can be measured using single photon emission computed tomography (SPECT) and radiolabeled antimyosin antibodies. Seven patients with acute myocardial infarction and one stable angina patient were injected with 2 mCi of Indium-111 labeled antimyosin antibodies. Planar image and SPECT was performed 24 hours later. None of the patients had history of prior infarcts, and none had undergone reperfusion techniques prior to the study, which was done within 4 days of the attack. Planar image showed all infarct patients to have postive uptakes in the cardiac region. The location of this uptake correlated to the infarct site as indicated by electrocardiography in most of the cases. The angina patient, however, showed no such abnormal uptake. Infarct size was determined from transverse slices of the SPECT image using a 45% threshold value obtained from a phantom study. Measured infarct size ranged from 40 to 192 gr. There was significant correlation between the infarct size measured by SPECT and that estimated from serial measurements of CPK (r=0.73, p<0.05). These date suggest that acute myocardial infarct size can be accurately measured from SPECT Indium-111 antimyosin imaging. This method may be especially valuable in situations where other methods are unreliable, such as early reperfusion technique, right ventricular infarct or presence of prior infarcts.

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