• Title/Summary/Keyword: Tc-99m DISIDA

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Quantitative evaluation of hepatic function for hepatic cancer patients using deconvolution technique in Tc-99m DISIDA SCAN (Tc-99m DISIDA SCAN에서 deconvolution 방법을 이용한 간암 환자의 잔여 간 기능의 정량적 평가)

  • Kim, Deok-Won;Kim, Su-Chan;Lee, Jong-Doo;Han, Kwang-Hyup
    • Proceedings of the KOSOMBE Conference
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    • v.1994 no.12
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    • pp.117-120
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    • 1994
  • 수술 전 간 기능이 저하되어 있는 간암환자의 경우 너무 많은 간 조직을 절제하면 남아있는 조직의 기능만으로는 생존하기 어려울 때가 있다 그러므로 수술전 간 기능의 평가를 정확히 할 수 있고 간절제 후에 잔여세포의 기능을 정확히 측정하는 것은 매우 중요한 의미를 갖게 된다. 현재의 일반적인 간 기능 검사나 Indocyanine 등을 이용하는 방법으로는 수술 후 잔여 간세포의 기능을 예측할 수 없다. 그리하여 본 연구에서는 수학적 deconvolution 방법을 이용하여 Hepatic extraction fraction(HEF)를 구하여 수술 후 잔여 간세포의 기능을 정량적으로 예측할 수 있는 software를 개발하고자 한다. 그리하여 간암 환자의 수술여부 및 절제부위의 크기를 결정할 수 있으며 또한 HEF로 신생아 황달의 원인인 간염과 간담도 폐쇄를 식별할 수 있다.

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Quantitative evaluation of hepatic function for pre- and post-surgery patients using deconvolution technique in Tc-99m DISIDA SCAN (Tc-99m DISIDA SCAN에서 deconvolution 방법을 이용한 외과적 수술 전후의 간의 정량적 평가)

  • Kim, S.C.;Kim, D.W.
    • Proceedings of the KOSOMBE Conference
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    • v.1997 no.05
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    • pp.366-369
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    • 1997
  • In this study, we measured upper right, lower right, upper left region to find the optimal region which represent liver function. We found that the upper right region is optimal because of high accuracy and low standard deviation. For normal subjects all the calculated HEFs were greater than 100% and all those of abnormal ones were less than 80%. Thus HEF can be assumed to discriminate abnormal livers from normal ones. It was found that the patients with surgical operation would survive if both the pre-and the post-operative HEFs are greater than 50%. Therefore HEF method can be a good estimator for surgeon to determine the surgical operation and to evaluate remaining hepatic function after surgery as well as it is reliable and simple.

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Clinical Characteristics in Patients with Biliary Obstruction Diagnosed by $^{99m}Tc-DISIDA$ Scan -In 9 Cases with Normal Ultrasonographic Findings- ($^{99m}Tc-DISIDA$ 간담도 스캔상 담도폐쇄로 진단된 환자의 임상적 특성 -초음파 검사상 정상 소견을 보인 9예를 중심으로-)

  • Park, Bong-Chul;Yang, Soo-Hyun;Che, Dong-Ho;Park, Sung-Ki;Byun, Jong-Hoon
    • The Korean Journal of Nuclear Medicine
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    • v.26 no.1
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    • pp.82-85
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    • 1992
  • To evaluate the role of hepatobiliary (DISIDA) scan in the diagnosis of biliary obstruction, we studied the clinical characteristics of 9 cases with biliary obstructuon, whose hepatobiliary scans and ultrasonography were not concordant (normal ultrasonography and abnormal hepatobiliary scan). The results were as follows; 1) The main chief complaints (89%) were abdominal pain, especially in RUQ area. The levels of serum bilirubin were elevated in 67% of patients $(normal\sim5.9mg/dl)$ and those of alkaline phosphatase were elevated in 78% of patients $(normal\sim724U/L)$. 2) The final diagnoses were CBD stones (67%), tumor (22%) and 3 cases were associated with C. sinensis. 3) The major obstruction sites were in distal CBD (89%). From the above results we concluded that hepatobiliary scan is a useful diagnostic method of biliary obstruction, especially in distal CBD lesion and early stage, in spite of normal ultrasonography.

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Diagnostic limitation and usefulness of 99mTc-DISIDA hepatobiliary scanning on neonatal cholestasis (신생아 담즙정체성 간 질환에서 담도 폐쇄증 감별을 위한 DISIDA 스캔의 진단적 한계성과 유용성)

  • Kim, Jung Mi;Choe, Byung-Ho;Jang, You Cheol;Oh, Ki Won;Cho, Min Hyun;Lee, Kyung Hee;Park, Jin-Young;Kim, Heng Mi
    • Clinical and Experimental Pediatrics
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    • v.49 no.7
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    • pp.737-744
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    • 2006
  • Purpose : To assess the usefulness of $^{99m}Tc-DISIDA$ scanning in the early evaluation of neonatal cholestasis and to verify the diagnostic value of this test in the differential diagnosis of biliary atresia. Methods : DISIDA scannings were performed and analyzed in 87 children(58 males and 29 females; age, 18-139 days, mean, 59.1 days) with neonatal cholestasis. Five groups according to the final diagnosis and the results of DISIDA scanning were analyzed by scatter plots using the parameters of age and the level of liver function tests(direct bilirubin, AST, ALT, ALP, GGT). The diagnostic sensitivity, specificity and accuracy of DISIDA scanning in the diagnosis of biliary atresia were compared between a higher bilirubin group and a lower bilirubin group(direct bilirubin level >5 mg/dL vs. <5 mg/dL) decided by the pattern of scatter plots. Results : DISIDA scannings in the diagnosis of biliary atresia were analyzed by high sensitivity(100 percent, 16/16) but lower specificity(70.4 percent, 50/71) and accuracy(75.9 percent, 66/87). False positivity(29.6 percent, 21/71) was higher in patients with a higher direct bilirubin level(42.5 percent for >5 mg/dL vs. 9.7 percent for <5 mg/dL, P<0.01). The age and the level of liver function tests(AST, ALT, ALP, GGT) analyzed by scatter plots revealed neither diagnostic value in predicting final diagnosis nor estimated the accuracy rate of DISIDA scanning in the evaluation of neonatal cholestasis. Conclusion : We suggest that DISIDA scannings should not be routinely used in evaluating neonatal cholestasis with elevated direct bilirubin level(>5 mg/dL), especially if it delays early diagnosis and surgical intervention.