• The Korean Journal of Nuclear Medicine
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• v.37 no.2
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• pp.128-134
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• 2003

섬유성 골이형성증은 비정상적인 섬유성 골조직으로 대체되며 느리게 진행하는 골병변이다. 섬유성 골이형성증과 부갑상선기능항진증은 흔하게 관찰되는 질환이나 McCune-Albright 증후군 없이 일차성 부갑상선기능항진증에 동반된 섬유성 골 이형성증은 거의 보고된바가 없다. Tc-99m MDP 골스캔이 섬유성 골이형성증의 진단에 유용하다고 알려져 있으나, Tc-99m MIBI 영상은 아직 보고된 바가 없다. 저자들은 McCune-Albright 증후군이 없이 부갑상선기능항진증에 동반된 섬유성 골 이형성증의 Tc-99m MIBI 스캔과 Tc-99m MDP 골스캔의 영상을 비교하였다. Tc-99m MDP 골스캔상 병변 부위에서 증가된 섭취 소견을 보였으며, Tc-99m MIBI 조기영상에서도 동일한 위치에서 섭취증가가 관찰되었다. 2시간 지연 Tc-99m MIBI 영상에서는 Tc-99m MIBI의 섭취가 배출되는 소견을 보였다. 섬유성 골이형성증 병변에서 Tc-99m MIBI 스캔이 유용할 것이라고 생각하며, 섬유성 골이형성증 병변에서 Tc-99m MIBI의 섭취를 증가시키는 인자에 대한 더 많은 연구가 필요할 것으로 생각한다.

• The Korean Journal of Nuclear Medicine
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• v.34 no.2
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• pp.119-128
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• 2000

Purpose: The aim of this study was to investigate the diagnostic role of $^{99m}Tc$-Tetrofosmin in detection of breast cancer and compared with that of $^{99m}Tc$-MIBI. Material and Methods: Forty-eight patients with a clinically palpable mass or abnormal mammographic or ultrasonographic findings had $^{99m}Tc-MIBI\;and\;^{99m}Tc$-Tetrofosmin scintimammographies after intravenous injection of 925 MBq of radiopharmaceuticals. The scintimammographs were correlated with histopathologic findings. Results: Thirty-three patients were diagnosed with breast cancer and 15 patients with benign breast diseases. The numbers of true positive, true negative, false positive, and false negative cases of $^{99m}Tc$-MIBI scintimammography were 29, 10, 5, and 4 respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of $^{99m}Tc$-MIBI scintimammographies were 87.8%, 66.7%, 85.3%, and 71.4% respectively. The numbers of true positive, true negative, false positive, and false negative cases of $^{99m}Tc$-Tetrofosmin were 31,10, 5, and 2 respectively. The sensitivity, specificity, positive predictive value, negative predictive value of $^{99m}Tc$-Tetrofosmin were 93.9%, 66.7%, 86.1%, and 73.3% respectively. One patient was false negative in both $^{99m}Tc-MIBI\;and\;^{99m}Tc$-Tetrofosmin acintimammographies and its size was 0.5 cm. Conclusion: $^{99m}Tc-Tetrofosmin\;and\;^{99m}Tc-MIBI$ were non-invasive and useful in detection of breast cancer and $^{99m}Tc$-Tetrofosmin was comparable to the $^{99m}Tc$-MIBI in detection of primary breast cancer.

• The Korean Journal of Nuclear Medicine
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• v.35 no.4
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• pp.268-273
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• 2001

Thymoma is the most common primary tumor of anterior mediastinum, accounting for 20% to 30% of all mediastinal tumors. The recurrence rate after total resection of the thymoma ranges 8% to 18%. We reported one patient of recurrent malignant thymoma imaged with Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA. Early and delayed Tc-99m MIBI and Tc-99m Tetrofosmin scintigraphies showed an increased uptake in the mediastinal area. Also, Tc-99m (V) DMSA scintigraphy revealed an increased uptake tn the corresponding area. Coronal SPECT images of Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA revealed increased uptake of each radiopharmaceutical in the tumor lesion corresponding to the mediastinal lesion on the chest CT. However, the normal blood pool activities of the heart and great vessels of Tc-99m (V) DMSA obscured the recurrent malignant thymoma. Although Tc-99m (V) DMSA is a useful tumor seeking agent, we recommend Tc-99m MIBI and Tc-99m Tetrofosmin SPECT rather than Tc-99m (V) DMSA to detect primary and recurrent malignant thymoma.

• The Korean Journal of Nuclear Medicine
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• v.28 no.2
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• pp.186-191
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• 1994

Tc-99m MIBI, a lipophilic cation, was reported as a useful agent for localization of lung cancer. The effect of radiation therapy on the uptake of Tc-99m MIBI in lung cancer, however, was not well evaluated. The aim of the present study was to elucidate the usefulness of Tc-99m MIBI SPECT in the localization and the assessment of radiotherapy in non-small cell lung cancer. Twenty patients(19 males and 1 female, mean age 59, 16 squamous cell ca and 4 adenoca) were studied with Tc-99m MIBI SPECT before radiation therapy. Eleven patients(10 males and 1 female, mean age 59, 8 squamous cell ca and 3 adenoca) were repeated the study 1 month after the completion of radiation therapy(mean dose 6453cGy). All patients showed positive uptakes of Tc-99m MIBI in their tumors. One patient showed a hot uptake in atelectatic area. There was no difference of Tc-99m MIBI uptakes between squamous cell ca and adenoca either on planar or tomographic images. Tc-99m MIBI uptake ratios of squamous cell ca and adenoca were $1.50{\pm}0.16$ and $1.45{\pm}0.15$ on planar images, and $2.73{\pm}0.46$ and $2.54{\pm}0.37$ on tomographic images, respectively. The concordance between radiological change(chest x-ray and CT) and change of Tc-99m MIBI uptakes was 9/11 (81.8% ). In conclusion, Tc-99m MIBI SPECT was useful in the localization of tumor and the assessment of radiation therapy in non-small cell lung cancer.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.234-242
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• 2000

Purpose: Tc-99m MIBI scintimammography has been validated as an useful non-invasive diagnostic tool for the primary breast cancer. But most studies have included small population of patients. We have experienced a large study population and investigated the diagnostic usefulness of Tc-99m MIBI scintimammography in detection of primary breast cancer and axillary lymph node metastasis. Materials and Methods: This study included 305 patients who underwent scintimammogtaphy for palpable breast masses or abnormal radiologic findings. Tc-99m MIBI scintimammography was performed 10 minutes after intravenous injection of 925 MBq of Tc-99m MIBI. If the early image revealed abnormal finding, 3 hour delayed image was also acquired. We calculated early and delayed lesion to non-lesion ratios (L/N). The pathologic diagnosis was obtained from surgical operation or FNAB and compared with the results of Tc-99m MIBI scintimammography. Results: Malignant breast diseases were 155 and benign ones were 150. Tc-99m MIBI scintimammography revealed 132 true positive, 23 false negative, 10 false positive, and 140 true negative cases. The sensitivity, specificity, positive predictive value and negative predictive value for the primary breast cancer detection were 85.2%, 93.4%, 92.9%, and 85.9%, respectively. The sensitivity, specificity, positive predictive and negative predictive values of Tc-99m MIBI scintimammography in detecting metastatic axillary lymph node involvement were 22%, 90.4%, 61.9% and 62.3%, respectively. Early L/N of malignant breast disease was significantly higher than that of benign one ($2.44{\pm}0.97\;vs\;1.94{\pm}0.78$, p=0.01). Delayed L/N had no significant difference between malignant and benign breast diseases ($1.94{\pm}0.52\;vs\;1.91{\pm}0.73$, p=0.43). Conclusion: Our study revealed that Tc-99m MIBI scintimammography was an useful diagnostic tool for the diagnosis of breast cancer. And early L/N ratio might provide complementary role in the detection of breast cancer. But the Tc-99m MIBI scintimammography had limited value in the detection of small breast cancer (less than 1 cm) and axillary lymph node metastasis.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.430-438
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• 1999

Purpose: We evaluated a rapid preparation procedures for the labeling and quality control of $^{99m}Tc$-ECD, $MAG_3$, and MIBI using microwave heating and Sep-Pak cartridges. Materials and Methods: $^{99m}Tc$ labeling of ECD, $MAG_3$, and MIBI kit preparation was performed according to the package inserts with microwave heating modification. Heating time was 10-15 sec, and heating was performed with 3 mm plastic bottle with screw cap to prevent radiation contamination. Labeling efficiency was obtained with $C_{18}$ or Alumina N Sep-Pak cartridges. Results: The radiochemical purity of $93{\sim}96%$ for $^{99m}Tc$-ECD and $95{\sim}99%$ for $^{99m}Tc$-MIBI was obtained using Alumina N Sep-Pak cartridge. The optimum irradiation time of microwave method for 3 ml $^{99m}Tc$-labeled radiopharmaceutical solution was 10 sec for $^{99m}Tc$-ECD and $^{99m}Tc$-MIBI, and 15 sec for $^{99m}Tc-MAG_3$. The results of quality control data with Sep-Pak cartridges were well correlated with TLC method. The total preparation time of these radiopharmcaeuticals was $5{\sim}6min$ including quality control procedure. Conclusion: This study demonstrates that radiopharmaceuticals preparation by microwave heating and quality control by Sep-Pak cartridges can be efficiently utilized as an alternative to the recommended method by manufacturer's manual.

• The Korean Journal of Nuclear Medicine
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• v.33 no.2
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• pp.152-162
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• 1999

Purpose: To determine whether $^{99m}Tc$-MIBI is recognized by the multidrug resistant P-glycoprotein (Pgp), we have measured quantitatively $^{99m}Tc$-MIBI uptake in cancer cells. The effects of various Pgp reversing agents on cellular $^{99m}Tc$-MIBI uptake were also investigated in the presence of multidrug resistance gene-1 (mdr1 gene) overexpression. Materials and Methods: We measured percentage uptake of $^{99m}Tc$-MIBI at different incubation temperatures both in mdr1 positive and negative cells. The effects of verapamil, cyclosporin, and dipyridamole on cellular uptake of $^{99m}Tc$-MIBI were also evaluated with or without overex-pression of mdr1 gene in cultured murine leukemia Ll210 cells. Results: The mdr1 gene expressing cell lines were effectively induced in in vitro with continuous application of low-dose adriamycin or vincristine. Cellular uptake of $^{99m}Tc$-MIBI was higher in mdr1 negative Ll210 cells than those of mdr1 positive cells, and higher when incubated in $37^{\circ}C$ than $4^{\circ}C$. In the presence of verapamil, cyclosporin or dipyridamole, $^{99m}Tc$-MIBI uptake was increased upto 604% in mdr1 positive cells. Conclusion: Cellular uptake of $^{99m}Tc$-MIBI is lower in leukemia cells over-expressing mdr1 gene, and MBR-reversing agents increase cellular uptake. These results suggest that $^{99m}Tc$-MIBI can be used for characterizing Pgp expression and developing MDR-reversing agents in vitro.

• The Korean Journal of Nuclear Medicine
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• v.31 no.3
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• pp.356-364
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• 1997

To evaluate the clinical utility of Tc-99m MIBI scan in the detection of residual thyroid tissue or metastatic lesion in postoperative thyroid cancer patients, we compared Tc-99m MIBI scan with I-131 diagnostic and therapeutic scan in 30 postoperative well-differentiated thyroid cancer patients. Thyroglobulin levels of both on and off thyroid hormone medication and antithyroglobulin antibody were tested [Tg(on), Tg(off)]. Positive rates for I-131 diagnostic and Tc-99m MIBI scan were 81% and 68% respectively. Concordance between I-131 diagnostic and Tc-99m MIBI scan was observed in 15 cases; 12 positive and 3 negative respectively. Among the 6 cases with negative I-131 diagnostic scan and positive Tc-99m MIBI scan, 4 were Positive in the therapeutic I-131 scan We concluded that Tc-99m MIBI scan maybe a useful complementary modality to the currently established method of I-131 scan and serum thyroglobulin level in the detection of recurrent or metastatic thyroid cancer, especially in the case of negative I-131 diagnostic scan.

• The Korean Journal of Nuclear Medicine
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• v.33 no.1
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• pp.76-83
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• 1999

Purpose: We performed this study to compare T1-201 and Tc-99m MIBI scans for the differentiation of malignant from benign breast mass. Materials and Methods: Thirty-eight female patients underwent T1-201 breast scan and thirty-two of them also underwent Tc-99m MIBI scan of the breast. After intravenous injection of 74-111 MBq of T1-201, early (10 minutes) and delayed (3 hours) images were obtained. Then, 555-740 MBq of Tc-99m MIBI was injected and images after 30 minutes were obtained. We compared T1-201 and Tc-99m MIBI scans with pathologic results. Results: Twenty-three patients were confirmed to have infiltrating duct carcinoma and fifteen patients to have benign breast mass by excisonal biopsy. The sensitivity of early and delayed T1-201 scan and Tc-99m MIBI scan in the detection of malignant breast lesion were 100% (23/23), 82% (18/22), and 90% (18120), respectively. The sensitivity of early T1-201 scan was significantly higher than that of delayed T1-201 scan (p<0.05). The specificity of early and delayed T1-201 scan and Tc-99m MIBI scan were 73% (l1/15), 73% (l1/15) and 83% (10/12), respectively (p: not significant). Three patients out of nine with fibroadenoma and one patient with atypical duct hyperplasia were false positive in both early and delayed T1-201 scans. The size of fibroadenoma with false positive in early and delayed T1-201 scan (4 cases) was larger than that of 11 fibroadenoma with true negative scan (p<0.01). Metastatic axillary lymph node involvement was present in fifteen patients. The sensitivity to detect metastatic nodes was 38% (5/13) for early T1-201 images, 15% (2/13) for delayed T1-201 images, 58% (7/12) for Tc-99m MIBI planar images and 67% (4/6) for Tc-99m MIBI SPECT. The sensitivity of Tc-99m MIBI planar or SPECT was significantly higher than that of delayed T1-201 images (p<0.05). Conclusion: Early T1-201 and Tc-99m MIBI scan are useful noninvasive methods to differentiate malignant from benign mass of breast Tc-99m MIBI scan was sensitive in detecting axillary lymph node metastasis in patients with breast cancer.

• The Korean Journal of Nuclear Medicine
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• v.38 no.6
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• pp.506-510
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• 2004

Purpose: We investigated whether Tc-99m MIBI imaging is useful to predict the response of drug treatment in patients with rheumatoid arthritis. Materials and Methods: 24 patients (15 women and 9 men, age $49{\pm}12$ year) rheumatoid arthritis and treated with disease modifying antirheumatic drugs (DMARDs) were included in this study. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured, and Tc-99m MIBI scan was obtained before drug treatment. Quantitative analysis of uptake in diseased joints was performed and expressed as joint-to background ratio (J/B) and percent retention (%R) of Tc-99m MIBI. Clinical symptoms were evaluated and graded from 0 (no) to 3 (severe) regarding to presence of tenderness and swelling. Results: J/B of the diseased joints were significantly correlated with ESR and CRP (p<0.05). A highly significant correlation was found between the improvement of clinical symptoms and %R of Tc-99m MIBI (p<0.05). Conclusion: The results demonstrate that Tc-99m MIBI scan may be used to predict the therapeutic response in patients with rheumatoid arthritis.