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Optimization of Subtraction Brain Perfusion SPECT with Basal/Acetazolamide Consecutive Acquisition (기저/아세타졸아미드 부하 연속 촬영 뇌관류 SPECT 최적화)

  • Lee, Dong-Soo;Lee, Tae-Hoon;Kim, Kyeong-Min;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.330-338
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    • 1997
  • This study investigated the method to adjust acquisition time(a) and injection dose (i) to make the best basal and subtraction images in consecutive SPECT. Image quality was assumed to be mainly affected by signal to noise ratio(S/N). Basal image was subtracted from the second image consecutively acquired at the same position. We calculated S/N ratio in basal SPECT images($S_1/N_1$) and subtraction SPECT images(Ss/Ns) to find a(time) and i(dose) to maximize S/N of both images at the same time. From phantom images, we drew the relation of image counts and a(time) and i(dose) in our system using fanbeam-high-resolution collimated triple head SPECT. Noise by imaging process depended on Poisson distribution. We took maximum tolerable duration of consecutive acquisition as 30 minutes and maximum injectible dose as 1,850MBq(50 mCi)(sum of two injections) per study. Counts of second-acquired image($S_2$), counts($S_s$) and noise($N_s$) of subtraction SPECT were as follows. $C_1$ was the coefficient of measurement with our system. $$S_2=S_1{\cdot}(\frac{30-a}{a})+background{\cdot}(1-\frac{30-a}{a})+C_1{\cdot}(30-a){\cdot}{\epsilon}{\cdot}(50-i)$$ $$Ss=S_2-\{S_1{\cdot}(\frac{30-a}{a})+background{\cdot}(1-\frac{(30-a)}{a})\}$$ $$Ns={\sqrt{N_2^2+N_1^2{\cdot}\frac{(30-a)^2}{a^2}}={\sqrt{S_2+S_1{\cdot}\frac{(30-a)^2}{a^2}}$$ In case of rest/acetazolamide study, effect(${\epsilon}$) of acetazolamide to increase global brain uptake of Tc-99m-HMPAO could be 1.5 or less. Varying ${\epsilon}$ from 1 to 1.5, a(time) and i(dose) pair to maximize both $S_1/N_l$ and Ss/Ns was determined. 15 mCi/17 min and 35mCi/13min was the best a(time) and i(dose) pair for rest/acetazolamide study(when ${\epsilon}$ were 1.2) and came to be used for our clinical routine after this study. We developed simple method to maximize S/N ratios of basal and subtraction SPECT from consecutive acquisition. This method could be applied to ECD/HMPAO and brain activation studies as well as rest/acetazolamide studies.

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Dipyridamole Induced Transient Left Ventricular Dysfunction in the Tl-201 Gated Myocardial SPECT (Tl-201 게이트 심근 SPECT에서 디피리다몰 부하로 유도된 일시적 좌심실 기능이상)

  • Won, Kyoung-Sook
    • The Korean Journal of Nuclear Medicine
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    • v.37 no.3
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    • pp.153-161
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    • 2003
  • Purpose: Recently the occurrence of dipyridamole stress-induced short term stunning was proven and it is reported that Bland Altman analysis by repeated acquisition Tl-201 gated myocardial SPECT (gSPECT) revealed the 95% limit of agreement for LVEF was 10.3 %. The purpose of this study was to investigate the clinical value of dipyridamole induced transient LV dysfunction on Tl-201 gSPECT. Materials and Methods: Total 93 patients were included and coronary angiography was peformed in all patients less than 2 month from gSPECT. The patients with myocardial infarction were excluded. All patients underwent both dipyridamole stress and 4-h redistribution Tl-201 gSPECT. Forty nine patients of total 93 showed normal coronary arteries (Group 1) and the remaining 44 patients had coronary artery disease (Group 2). We compared LV EF, EDV and ESV during post-stress and 4-h redistribution period calculated by gSPECT using quantitative gated SPECT software and the incidence of dipyridamole induced transient LV dysfunction between group 1 and 2. The criteria for transient LV dysfunction was defined more decrease ${\geq}11%$ of LVEF during post-stress than 4-h redistribution according to previous reported Bland Altman analysis. Results: During post-stress and 4-h redistribution average of 3.1% increment in LVEF, 6.6% increment in LVEDV and 0.7% decrement in LVESV were shown after stress in Group 1, whereas 4.1% decrement, 9.7% increment and 7.2% increment in Group 2 respectively. Dipyridamole induced transient LV dysfunction was only detected in group 2 (18.2%) and not in group 1. It was more frequently observed in triple vessel disease and left main disease (31.8%, N=22) than one and two vessel disease (4.5%, N=22). Conclusion: As with Tc-99m myocardial agent post-stress LV dysfunction was observed in dipyridamole Tl-201 gSPECT. It was only detected in CAD and more frequently occurred in multivessel disease. Thus this finding seems to provide additional information in the diagnosis of coronary artery disease and prediction of prognosis.

Viability Assessment with T1-201 Rest-24 hour Delay Redistribution SPECT before Coronary Artery Bypass Graft in Coronary Artery Diseases (관상동맥 질환에서 우회로 수술 전 T1-201 휴식-24시간 지연 심근 관류 SPECT를 이용한 심근생존능의 평가)

  • Yoon, Seok-Nam;Kim, Ki-Bong;Lee, Won-Woo;Chung, June-Key;Lee, Myung-Chul;Seo, Jung-Don;Koh, Chang-Soon;Lee, Dong-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.493-501
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    • 1996
  • To assess contribution of T1-201 rest-24 hour delay redistribution in detection of viable myocardium, we studied the predictive value of this redistribution in 17 patients who peformed rest-24 hour delay perfusion SPECT before bypass surgery. Regional wall motion was compared with gated SPECT in 10 patients and echocardiography in 7 patients before and after bypass surgery. Rest and 24 hour delayed uptakes were scored from 0 (normal perfusion) to 3 (defect). In rest SPECT, 56 segments showed perfusion decrease. Thirty four segments(61%) improved after surgery and were defined as viable Nineteen(34%) segments had more uptake of T1-201 at 24 hour delay, and the other 37 segments did not. In 81%(25/31) of segments with mildly decreased perfusion, wall motion after bypass surgery improved, 57% (8/14) of segments with severely decreased perfusion improved, and 9%(1/11) of segments with defects improved. In 14 among 19 segments which had more T1-201 uptakes at 24 hour delay, wall motion was improved(positive predictive value of redistribution: 74%). 20 among 37 segments which had persistent decreases in rest-24 hour redistribution improved and 17 did not(negative predictive value: 46%). Segments having severe perfusion decrease or defects showed improved wall motion after surgery in 64%(7/11), if it had redistribution at delay. Segments with either mildly decreased uptake in resting or rest-delayed redistribution showed improved wall motion in 76%(32/42). Among the 14 segments which showed improvement in wall motion, 10 had partial reversibility in stress-rest images and the other 4 had persistent perfusion defects in stress-rest images. These 4 segments were found viable only with rest-24 hour delayed perfusion SPECT. We concluded that rest T1-201 uptake or redistribution at 24 hour delay should be referred as an evidence to warrant postoperative improvement of abnormal wall motion and we could predict myocardial viability with preoperative rest-24 hour delay perfusion SPECT in the segments with rest perfusion decreases.

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Quantitative Assessment of the Radiation Exposure during Pathologic Process in the Sentinel Iymph Node Biopsy using Radioactive Colloid (방사성 콜로이드를 이용한 감시림프절 생검 병리처리과정에서 방사선 피폭의 정량적 평가)

  • Song, Yoo-Sung;Lee, Jeong-Won;Lee, Ho-Young;Kim, Seok-Ki;Kang, Keon-Wook;Kook, Myeong-Cherl;Park, Weon-Seo;Lee, Geon-Kook;Hong, Eun-Kyung;Lee, Eun-Sook
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.4
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    • pp.309-316
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    • 2007
  • Purpose: Sentinel lymph node biopsy became the standard procedure in early breast cancer surgery. Faculty members might be exposed to a trace amount of radiation. The aim of this study is to quantify the radiation exposure and verify the safety of the procedure and the facilities, especially during pathologic process. Materials and Methods: Sentinel lymph node biopsies with Tc-99m human serum albumin were performed as routine clinical work. Exposed radiation doses were measured in pathologic technologist, nuclear medicine technologist, and nuclear medicine physician using a thermoluminescence dosimeter (TLD) during one month. We also measured the residual radioactivities or absorbed dose rates, the exposure distance and time during procedure, the radiation dose of the waste and the ambient equivalent dose of the pathology laboratory. Results: Actual exposed doses were 0.21 and 0.85 (uSv/study) for the whole body and hand of pathology technologist after 47 sentinel node pathologic preparations were performed. Whole body exposed doses of nuclear medicine physician and technologist were 0.2 and 2.3 (uSv/study). According to this data and the exposure threshold of the general population (1 mSv), at least 1100 studies were allowed in pathology technologist. The calculated exposed dose rates (${\mu}$ Sv/study) from residual radioactivities data were 2.47/ 22.4 ${\mu}$ Sv (whole body/hand) for the surgeon; 0.22/ 0 ${\mu}$ Sv for operation nurse. The ambient equivalent dose of the pathology laboratory was 0.02-0.03 mR/hr. The radiation dose of the waste was less than 100 Bq/g and nearly was not detected. Conclusion: Pathologic procedure relating sentinel lymph node biopsy using radioactive colloid is safe in terms of the radiation safety.(Nucl Med Mol Imaging 2007;41(4);309-316)

Comparison Study between Myocardial Velocity obtained from Gated Myocardial SPECT and Myocardial Functional indices with a Focus on Myocardial Perfusion (게이트 심근 관류 SPECT에서 구한 심근 속도와 심근 관류를 중심으로 한 심근 기능 지표와의 비교연구)

  • Ha, Jung-Min;Jeong, Shin-Young;Bom, Hee-Seung;Lee, Byeong-Il
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.5
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    • pp.386-394
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    • 2009
  • Purpose: We aimed to assess the myocardial velocity on gated myocardial perfusion SPECT (gated MPS), to compare myocardial velocity between patients without coronary artery disease (CAD) and CAD patients and to assess the correlation of myocardial velocity and perfusion and wall thickening on CAD group. Materials and Methods: Seventeen patients without CAD (M:F=9:8, mean age $61.8{\pm}11.1$ yrs: group A) and thirty-nine patients with CAD (M:F=18:21, mean age $66.9{\pm}8.1$ yrs : group B) had undergone one-day adenosine stress gated MPS. In twenty segment model, 12 segments (except apical and basal segments) of each patient were included. We obtained systolic and diastolic gate ratio in left ventricular volume curve by eight frames per cardiac cycle on gated MPS. Using the systolic and diastolic gate ratio and R-R time of each patient, we obtained systolic and diastolic time ratio. The myocardial velocity was defined as wall thickening over systolic or diastolic time. Results: We presented normal range of myocardial velocities according segments and territories of coronary artery. The myocardial velocity of group B was significantly lower than group A (p=0.00). There was no significant difference between the myocardial velocity of group B with preserved EF and group A. The stress systolic velocity significantly correlated with regional myocardial perfusion in group B with preserved EF (p=0.00) as well as decreased EF (p=0.01). In group B, stress perfusion of segments which had decreased wall thickening and decreased myocardial velocity was significantly lower than segments which had decreased wall thickening and preserved myocardial velocity (p=0.01). Conclusion: The new functional index of velocity will be used as an useful of gated MPS.

The Effects of Discrepancy in Reconstruction Algorithm between Patient Data and Normal Database in AutoQuant Evaluation: Focusing on Half-Time Scan Algorithm in Myocardial SPECT (심근 관류 스펙트에서 Half-Time Scan과 새로운 재구성법이 적용된 정상군 데이터를 기반으로 한 정량적 분석 결과의 차이 비교)

  • Lee, Hyung-Jin;Do, Yong-Ho;Cho, Seong-Wook;Kim, Jin-Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.122-126
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    • 2014
  • Purpose: The new reconstruction algorithms (NRA) provided by vendor aim to shorten the acquisition scan time. Whereas depending on the installed version AutoQuant program used for myocardial SPECT quantitative analysis did not contain the normal data that NRA is applied. Thus, the purpose of this paper is to compare the results according to AutoQuant versions in myocardial SPECT applied NRA and half-time scan (HT). Materials and Methods: Rest Tl and stress MIBI data of total 80 (40 men, 40 women) patients were gathered. Data were applied HT acquisition and ASTONISH (Philips) software which is NRA. Modified autoquant of SNUH and old version of AutoQuant (full-time scan) provided by company were compared. Comparison groups were classified as coronary artery disease (CAD), 24 hrs delay and almost normal patients who have a simple pain patient. Perfusion distribution aspect, summed stress score (SSS), summed rest score (SRS), extent and total perfusion deficit (TPD) of each 25 patient who have above diseases were compared and evaluated. Results: The case of CAD, when using re-edited AutoQuant (HT) SSS and SRS showed about 30% reduction (P<0.0001), Extent showed about 38% reduction and TPD showed about 30% reduction in the tendency (P<0.0001). In the score of the perfusion, especially on the part of infero-medium, infero-apical, lateral-medium and lateral-apical regions were the biggest change. The case of the 24 hrs delay patient SRS (P=0.042), Extent (P=0.018) and TPD (P=0.0024) showed about 13-18% reduction. And the case of simple pain patient, comparison of 4 results showed about 5-7% reduction. Conclusion: This study was started based on expectation that results could be affected by normal patient data. Normal patient data is possible to change by race and gender. It was proved that combination of new reconstruction algorithm for reducing scan time and analysis program according to scan protocol with NRA could also be affected to results. Clinical usefulness of gated myocardial SPECT is possibly increased if each hospital properly collects normal patient data for their scan acquisition protocol.

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Abosrbed Dose Measurements and Phantom Image Ecaluation at Minimum CT Dose for Pediatric SPECT/CT Scan (소아 SPECT/CT 검사를 위한 최저조건에서의 피폭선량측정 및 팬텀의 영상평가)

  • Park, Chan Rok;Choi, Jin Wook;Cho, Seong Wook;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.82-88
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    • 2014
  • Purpose: The purpose of study was to evaluate radiation dose for pediatric patients by changing tube voltage (kVp) and tube current (mA) at minimum conditions. By evaluating radiation dose, we want to provide dose reduction for pediatric patients and maintain good quality of SPECT/CT images. Materials and Methods: Discovery NM/CT 670 Scanne was used as SPECT/CT. Tube voltages are 80 and 100 kvP. Tube currents are 10, 15, 20, 25 mA. Using PMMA (Polymethyl methacrylate) Phantom, radiation dose which were calculated at center and peripheral dose and SNRD (Signal to Noise Ratio Dose) were evaluated. Using the CT performance phantom, spatial resolution was evaluated as the MTF (Modulation Transfer Function) graph. Jaszczak phantom was used for SPECT image evaluation by CNR (Contrast to Noise to Ratio). Results: Radiation dose using the PMMA phantom was higher peripheral dose than center dose about 7%. SNRD were 7.8, 8.2, 8.3, 8.8, 8.8, 9.9, 9.8, 9.6 for 80 kVp 10, 15, 20, 25 mA, 100 kVp 10, 15, 20, 25 mA. We can distinguish 35, 45, 70, 71, 52, 58, 90, 110 linepair for 80 kVp 10, 15, 20, 25 mA, 100 kVp 10, 15, 20, 25 mA at resolution with MTF. CNR of SPECT images using CT attenuation map were 57.8, 57.7, 57.1, 56.7, 56.6, 56.7, 56.7, 56.7% for 80 kVp 10, 15, 20, 25 mA, 100 kVp 10, 15, 20, 25 mA. Conclusion: In this study, radiation dose for pediatric patients showed decreased low dose condition. And SNRD value was similar in all condition. Resolution showed higher value at 100kVp than 80kVp. for CNR, there was no significant difference. we should take additional study to prove better quality and dose reduction.

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Effects of Organic Salts Fortified with Seaweed Components on Blood Pressure, Serum Minerals, and Hematochemicals in Spontaneously Hypertensive and Normotensive Rats (해조성분 강화염이 본태성 고혈압쥐와 정상혈압쥐의 혈압, 혈청 중 미네랄 함량 및 생화학적 특성에 미치는 영향)

  • Kim, Young-Myoung;Byun, Jee-Young;Han, Chan-Kyu;Sung, Ki-Seung;Namgung, Bae
    • Korean Journal of Food Science and Technology
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    • v.41 no.2
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    • pp.196-202
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    • 2009
  • The effects of the salts fortified with seaweed functional components on blood pressure, serum minerals, and hematochemicals in spontaneously hypertensive rats (SHR/NCrj) and normotensive rats (WKY/NCrj) were investigated. SHR and WKY rats were assigned to four groups, with 8 and 6 rats in each group: laver salt (A), fucoidan+laver high salt (B), fucoidan + laver low salt (C) and refined salt as a control (D). The final blood pressure (BP) of SHR and WKY species in contrast with reference BP were low in groups A and C as compared with control group. In terms of serum mineral content, $Na^+$ levels were similar in SHR and WKY, but $K^+$ levels were higher in the group B in SHR. Serum triglyceride levels were lower in groups A and C, but the levels of HDL- and LDL- cholesterol were significantly higher and lower in group A than those of controls, respectively (p<0.05). These results demonstrated that the salts fortified with laver might suppress blood pressure in rats, and also may improve mineral and lipid metabolism.

Physicochemical Characteristics of Sweetpotato (Ipomoea batatas (L.) Lam) Starch Depending on Cultivation Periods (재배기간에 따른 고구마(Ipomoea batatas (L.) Lam) 전분의 이화학적 특성)

  • Han, Seon-Kyeong;Song, Yeon-Sang;Ahn, Seung-Hyun;Yang, Jung-Wook;Lee, Hyeong-Un;Lee, Joon-Seol;Chung, Mi-Nam;Nam, Sang-Sik;Choi, In-Hoo;Park, Keun-Hyung
    • Korean Journal of Food Science and Technology
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    • v.46 no.6
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    • pp.750-756
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    • 2014
  • This study was performed to understand the effect of cultivation periods on the physicochemical characteristics of the starch of five sweetpotato cultivars, cultivated in Muan, Korea. Starch, protein, and ash contents increased with increased cultivation period, whereas amylose content decreased. Rapid viscosity analysis showed that the pasting temperature, peak viscosity, breakdown, setback and final viscosity increased with increased cultivation period. However, trough and final viscosity decreased. Although the onset temperature and peak temperature values increased, the conclusion temperature did not show any consistent patterns by differential scanning calorimetry. X-ray diffraction showed that the starch samples had C-type crystallinity irrespective of the cultivation period and cultivar. The starch granules were dominantly round and oval, or polygonal irrespective the cultivation period. The bigger the particle size was, the longer the cultivation period was.

A Study on Luxury Prohibition of Korean Personal Ornaments (한국장신구의 사치 금제 고찰)

  • 추원교
    • Archives of design research
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    • v.2 no.1
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    • pp.43-62
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    • 1989
  • The luxury is the expression of human being's ornament instinct. In this study, in order to grasp the moulding system of the Korean's personal ornaments, the process of luxury prohibition was reviewed to search for to which direction the ornaments developed in the frame of the prohibited style connected closely to the character of the personal ornaments. The proiod was fixed from the old society to the late Chosun dynasty era. The beginning of the luxury in Korea seems to be the start of the luxury burial at the time of funeral in the age of Koguryo., In the era of Koguryo, 10th year of King Dongmyung (B. C. 28), in the era of Baekje, 27th year of King Koi(260), the prohibition of dress regulation and the style of dress were conducted. The prohibition of personal ornaments in Silla was started from King Bup:Heung, and in the 9th year of King Heung-Duk, the prohibition was conducted in order to correct the luxury of the nobles and set up the social discipline. In the 11 th of King Il-Sung-Ni-Sa-Kum, the use of gold, silver and jade was prohibited in the civilian circles. The prohibition of Silla was succeeded to Koryo era, and in the 7th year of King Kwangjong(956), the system of Baekgwan Gongbok(uniform for government officials) was set up, and the system of Sasek Gongbok(four color official uniform) was set up in the 11 th year of the same King, and the prohibition of the personal ornaments such as crown and band is considred to have been conducted. The prohibition of gold and silver was conducted in the first year of King Sungjong(982), and in the 4th year of King Chungryul(l260), the order of wearing the dress and hat in accordance with the Yusan dynasty and the Mongolian customs were widely circulated in the royal court and vivilian circles. The strong influence of Mongolia made the taste of the traditional personal ornaments laste. The personal ornaments were used for the nobles until the age of the Unified Sillar but even the common people could use them in case they were rich, and such a circumstances made the use of foreign goods inflated. The prohibition of Koryo era was aimed at the prohibition of the foreign goods of luxury, and the classification of the social status.In the age of Chosun Dynasty, the production of gold and silver was feeble indeed but the oute reason of the prohibition was to eradicate the luxurious tendency, elevate the custom of eradicate the luxurious tendency, elevate the custom of thrift, and moreover, the gold, silver and jade were no the products of Korea and the prohibition was conducted but the true reason was afor the tribute tt China and the classification of status. The prohibition of Chosun dynasty was conducted first in the June of the 3rd year of King Taejo The major contents of prohibition was no use of gold, silver and jade, coral, agate, amber, etc. of th, wives of the Dang-Sang-Kwan (Court Nobleman) or their sons and daughters, and the same pheno menon was common even at the time of marriage. The people engaged in the secret trade there of wert beheaded. The personal ornaments in the prohibition were the pendent trinket, Binyo (crossbar) ceremonial ornamental hat, ring, earring, ornamental knife, hat string, hat ornament, belt, etc. Thl luxurious marriage expenses out of the luxury was severe, and lose of the marriageable age because 0 non-preparing the marriage goods was the national evil. The prohibition oC luxury was hard to bt kept to the nobles or rich people, the same as old days and present days. The prohibition of th{ luxury and personal ornaments of Korea had nothing to do with the commons, and it was limited tc the nobles and rich people. The prohibition was aimed to cultivating the custom of frugality by eradicating the luxurious atmosphere, but it was chiefly due to the tribute to the China and tht discrimination of the. status. We can say that the recent personal ornament was the flower of handi craft industry bloomed in the prohibition and regulation.

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