• The Korean Journal of Nuclear Medicine
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• v.34 no.5
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• pp.381-392
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• 2000

Purpose: We compared the reproducibility of $^{201}Tl\;and\;^{99m}Tc$-sestamibi (MIBI) gated SPECT measurement of myocardial function using the Germano algorithm Materials and Methods: Gated SPECT acquisition was repeated in the same position in 30 patients who received $^{201}Tl$ and in 26 who received $^{99m}Tc$-MIBI. The quantification of end-diastolic volume (EDV), end-systolic volume (ESV), and ejection fraction (EF) on $^{201}Tl\;and\;^{99m}Tc$-MIBI gated SPECT was processed independently using Cedars quantitative gated SPECT software. The reproducibility of the assessment of myocardial function on $^{201}Tl$ gated SPECT was compared with that of $^{99m}Tc$-MIBI gated SPECT Results: Correlation between the two measurements for volumes and EF was excellent by the repeated gated SPECT studies of $^{201}Tl$ (r=0.928 to 0.986; p<0.05) and $^{99m}Tc$-MIBI (r=0.979 to 0.997; p<0.05). However, Bland Altman analysis revealed the 95% limits of agreement (2 SD) for volumes and EF were tighter by repeated $^{99m}Tc$-MIBI gated SPECT (EDV: 14.1 ml, ESV: 9.4 ml and EF: 5.5%) than by repeated $^{201}Tl$ gated SPECT (EDV: 24.1 ml, ESV: 18.6 ml and EF: 10.3%). The root mean square (RMS) values of the coefficient of variation (CV) for volumes und EFs were smaller by repeated $^{99m}Tc$-MIBI gated SPECT (EDV: 2.1 ml, ESV 2.7 ml and EF: 2.3%) than by repeated $^{201}Tl$ gated SPECT (EDV: 3.2 ml, ESV: 3.5 ml and EF: 5.2%). Conclusion: $^{99m}Tc$-MIBI provides more reproducible volumes and EF than $^{201}Tl$ on repeated acquisition gated SPECT. $^{99m}Tc$-MIBI gated SPECT is the preferable method for the clinical monitoring of myocardial function.

• Childhood Kidney Diseases
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• v.18 no.1
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• pp.36-41
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• 2014

Purpose: Urinary tract infections (UTIs) are the most common source of bacterial infections in infants and young children. Accurate diagnosis and treatment is important because of their association with renal scarring, which can lead to complications. Urine endothelin-1 (ET-1) is the major renal isoform produced and released by renal mesangial cells in response to glomerular injury. This study aimed to investigate whether urinary levels of ET-1 can be used as a biomarker for UTI diagnosis. Method: We conducted a prospective study using medical records of 70 patients below the age of 18 years, who visited Chung-Ang University Hospital from July 2012 to July 2013. We classified the patients into the UTI and control groups based on urine culture studies. The UTI group was further divided into upper and lower UTI groups using 99m-Technetium dimercaptosuccinic acid scintigraphy. Urine ET-1 was measured using enzyme linked immunosorbent assay with 0.3 mL urine. Results: The UTI and control groups were comprised of 45 and 25 patients, respectively. Mean urine ET-1 levels were significantly higher in the UTI group than in the control group ($1.41{\pm}0.35$ pg/mL vs. $0.33{\pm}0.07$ pg/mL, P =0.04). There was no significance difference in the quantitative value between the upper and lower UTI groups (P =0.552). There was no correlation between urine ET-1 and serum C-reactive protein (Pearson correlation [R]=0.24), urine ET-1 and serum white blood cell count (R=0.19). Conclusion: Our study suggests that urine ET-1 can be used for early diagnosis of UTI in children.

• Journal of the Korean Society of Radiology
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• v.11 no.1
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• pp.43-48
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• 2017

Measurement of bone marrow measurements may occur if bone marrow examination performed with bone marrow examination (bone marrow examination) and bone density (bone scan) are performed together recently. Thus, it was examined in clinical aspects that $^{99m}Tc-MDP$ compounds were affected by bone mineral density measurements. The average age of the participants in the experiment was $35.17{\pm}9.45$ and the patient fractures of the lumbar vertebrae that could affect the metabolic disease and bone density measurements affecting the metabolic disease of the 17 subjects. 6 patients with normal bone mineral density T-scores>-1.0 in 12 patients were analyzed before and after the administration of $^{99m}Tc-MDP$. In the lumbar spine, the average of $0.975{\pm}0.084g/cm^2$ and $0.966{\pm}0.078g/cm^2$ were increased by $0.009g/cm^2$. respectively In the right proximal femur, mean values were $0.909{\pm}0.078g/cm^2$ and $0.913{\pm}0.086g/cm^2$. In the right proximal thigh, mean values were $0.909{\pm}0.078g/cm^2$ and $0.913{\pm}0.08 g/cm^2$, respectively, which decreased by $0.004g/cm^2$. In the left side proximal femur, mean $0.887{\pm}0.099g/cm^2$ and $0.881{\pm}0.103g/cm^2$, respectively, increased by $0.007g/cm^2$. Therefore, the BMD changes in the lumbar region were larger than that in the proximal thigh. In addition, $^{99m}Tc-MDP$ did not affect the BMD. And a bone scan test using a technetium-labeled compound emitting a gamma-ray energy of 140 keV did not significantly affect bone density measurements. However, if the nuclear medical examination and the osteoporosis test are to be performed together, the examination should be carried out at intervals considering the exposures of the patient.

• The Korean Journal of Nuclear Medicine
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• v.25 no.1
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• pp.117-121
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• 1991

Technetium-99m-hexamethylpropyleneamine oxime $(^{99m}Tc-HM-PAO)$ is a neutral-lipophilic chelate which is used for scanning cerebral blood flow. The labeling efficiencies of $^{99m}Tc-HM-PAO$ is known to be sensitive to the amount of pertechnetate added and the quality of the pertechnetate. Because of these factors, the manufacture recommends that HM-PAO kits be reconstituted with a maximum of 30 mCi pertechnetate which was eluted <4 hr earlier from a generator which had been eluted < 24 hr previously. So we measured the labelling efficiencies and the decomposition rate constant according to the amount of pertechnetate added, the volume of pertechnette added, and generator in-growth time. We used the 3-system chromatographic methods (paper & ITLC-SG chromatography) which analyzed the labelling efficiencies of the $^{99m}Tc-HM-PAO$. There was no significant difference in labelling efficiencies between variable pertechnetate acitvities added. ($39.9{\pm}4.9\;mCi:\;87.8{\pm}5.1\;(%)$, $60.8{\pm}5.0\;mCi:\;90.7{\pm}2.2\;(%)$, $79.0{\pm}6.0\;mCi:\;86.8{\pm}3.9\;(%)$, $106.6{\pm}11.6\;mCi:\;87.7{\pm}1.2\;(%)$, p>0.05) No significant difference in labelling efficiencies were found between pertechnetate of 4ml and 5ml. (4ml : $89.1{\pm}3.2(%)$, 5ml: $87.3{\pm}4.0(%)$, p>0.05). There was no difference between 1-6 and 10-48 hr of generator in-growth time. (1-6 hr: $87.8{\pm}4.0(%)$, 10-48 hr: $89.6{\pm}1.6(%)$, p>0.05) The mean value of decomposition rate constant was $0.196{\pm}0.097\;(hr^{-1})$, and there were no difference according to the amount of pertecnetate added and the volume of pertecnetate added, ($39.9{\pm}4.9\;mCi:\;0.208{\pm}0.059\;(hr^{-1})$, $60.8{\pm}5.0\;mCi:\;0.191{\pm}0.100\;(hr^{-1})$ $79.0{\pm}6.0\;mCi:\;0.192{\pm}0.118\;(hr^{-1})$, $106.6{\pm}11.6\;mCi:\;0.212{\pm}0.030\;(hr^{-1})$, p>0.05, 4 ml: $0.200{\pm}0.074\;(hr^{-1})$, Sml: $0.193{\pm}0.115\;(hr^{-1})$, p>0.05). In the case of using the first eluate, the labelling efficiency of $^{99m}Tc-HM-PAO$ W3S 82.1%. These data suggest that there were no significant alteration in labelling efficiency of $^{99m}Tc-HM-PAO$ according to the considerable range of pertechnetate activities and volume added, and generator in-growth time. Also, it was shown that one vial of HM-PAO kit supplied the $^{99m}Tc-HM-PAO$ which was used for 3-4 patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.29-33
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• 2011

Background and Purpose: Uniformity is the one of the important quality control features with respect to gamma cameras. To maintain adequate uniformity, we must acquire suitable flood table (=flood map) data because the flood table effects energy, and the type or dose of input radiation. Therefore, in this study we evaluated the difference in uniformity when uniformity does not match between the type of input radiation and the flood table data or collimator type. Subjects and Methods: For input radiation, we prepared 370 MBq of $^{57}Co$, $^{99m}Tc$, and $^{201}Tl$. Using SKYLight (Philips) and Infinia gamma cameras (GE), we acquired nine uniformity data that were corrected by technetium, cobalt flood table and did not corrected image for the three sources. Additionally, we acquired two uniformity images with a collimator that were corrected by intrinsic and extrinsic flood tables. Using this data, we evaluated and compared the uniformity values. Results: In the case of the SKYLight gamma camera, the uniformities of the images that matched between the input radiation and flood table with respect to $^{99m}Tc$ and $^{57}Co$ were better than the unmatched uniformity (3.96% vs. 5.69% ; 4.9% vs. 5.91%). However, because there was no thallium flood table, the uniformities of images at Tl were significantly incorrect (7.49%, 7.03%). The uniformities of the Infinia gamma camera had the same pattern as the SKYLight gamma camera (3.7% vs. 4.5%). Moreover, the uniformity of the $^{99m}Tc$ image acquired with a collimator and corrected by an extrinsic flood table was better than the intrinsic flood table (3.96% vs. 6.28%). Conclusion: Correcting an image by a suitable flood table can help achieve better uniformity for a gamma camera. Therefore, we have to acquire images with suitable uniformity correction, and update the flood table periodically. Whenever we acquire a nuclear medicine image, we always have to check the appropriate flood table according to the acquired condition.

• Journal of Chest Surgery
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• v.35 no.3
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• pp.171-176
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• 2002

Background: Blood-foreign interaction cause activation of coagulation and inflammatory process that may lead to multiorgan dysfunction and determine the surgical outcomes. Of the methods for assessing the biocompatibility, the platelet adhesion study is considered as the most valuable evaluation step in blood-foreign interaction. As the most studies have used in-vitro or ex-vivo conditions, we have developed a technique of quantification for platelet adhesion on the blood contact surface by using in-vivo injection of radioactive platelets. Material and Method: A coupled bypass circuit was designed to connect the proximal and descending thoracic aorta in 6 piglets(20∼25 Kg). One side of the circuit tube was consisted of a heparin coated PVC tube(10mm in ID, n=6, Experimental group), and the other, a non-heparin coated PVC tube(10mm in ID, n=6, Control group). After cannulation, the blood was circulated through the circuit for 2 hours. Platelet concentrate was prepared from homologous pig blood 24 hours before the experiment. The platelet concentrate was incubated with Tc-99m-HMPAO for 30 min and then centrifuged for 10 min. The supernatant was discarded and the radio-labeling efficacy was measured. The radio-labeled platelet concentrate was mixed with the autologous plasma to make the volume 5 ml, and the mixture was injected intravenously into the experimental animal. After 2 hour circulation, 5 pieces of the specimen(10mm in length each) were obtained from each PVC tube. The radioisotopes were counted with a gamma counter(Cobra ll, Packard, USA), and the ratio of radioisotope count was compared between the control and experimental group. Result: The radioisotope count number was 537.3221.1 Ci/min in the control group and 311.1 184.5 Ci/min in the experimental group(p=0.0104). The ratio between the groups was 1 to 0.58 (p=0.004). Conclusion: In vivo quantification using technetium-99m-HMPAO labeled platelets is simple and reproducible in evaluating platelet adhesion on a foreign surface. We suggest this technique to be a useful tool for blood compatibility test.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.3
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• pp.177-185
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• 2006

Purpose: Purpose of this study is to synthesize $^{99m}Tc$-labeled transferrin for injection imaging and to compare it with $^{67}Ga$-titrate for the detection of infectious foci. Materials and methods: Succinimidyl 6-hydrazino-nicotinate hydrochloride-chitosan-transferrin (Transferrin) was synthesized and radiolabeled with $^{99m}Tc$. Labeling efficiencies of $^{99m}Tc$-Transferrin were determined at 10 min, 30 min, 1 hr, 2 hr, 4 hr and 8 hr. Biodistribution and imaging studies with $^{99m}Tc$-Transferrin and $^{67}Ga$-citrate were performed in a rat abscess model induced with approximately $2{\times}10^8$ colony forming unit of Staphylococcus aureus ATCC 25923. Results: Successful synthesis of Transferrin was confirmed by mass spectrometry. Labeling efficiency of $^{99m}Tc$-Transferrin was $96.2{\pm}0.7%,\;96.4{\pm}0.5%,\;96.6{\pm}1.0%,\;96.9{\pm}0.5%,\;97.0{\pm}0.7%\;and\;95.5{\pm}0.7%$ at 10 min, 30 min, 1 hr, 2 hr, 4 hr and 8 hr, respectively. The injected dose per tissue gram of $^{99m}Tc$-Transferrin was $0.18{\pm}0.01\;and\;0.18{\pm}0.01$ in the lesion and $0.05{\pm}0.01\;and\;0.04{\pm}0.01$ in the normal muscle, and lesion-to-normal muscle uptake ratio was $3.7{\pm}0.6\;and\;4.7{\pm}0.4$ at 30 min and 3 hr, respectively. On image, lesion-to-background ratio of $^{99m}Tc$-Transferrin was $2.18{\pm}0.03,\;2.56{\pm}0.11,\;3.08{\pm}0.18,\;3.77{\pm}0.17,\;4.70{\pm}0.45\;and\;5.59{\pm}0.40$ at 10 min, 30 min, 1 hr, 2 hr, 4 hr and 10 hr and those of $^{67}Ga$-citrate was $3.06{\pm}0.84,\;4.12{\pm}0.54\;and\;4.55{\pm}0.74 $ at 2 hr, 24 hr and 48 hr, respectively. Conclusion: Transferrin is successfully labeled with $^{99m}Tc$, and its labeling efficiency was higher than 95% and stable for 8 hours. $^{99m}Tc$-Transferrin scintigraphy showed higher image quality in shorter time compared to $^{67}Ga$-citrate image. $^{99m}Tc$-transferrin is supposed to be useful in the detection of the infectious foci.

• The Korean Journal of Nuclear Medicine
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• v.35 no.6
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• pp.378-388
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• 2001

Purpose: In this study, we developed a new method for the determination of renal depth with anterior and posterior renal scintigrams in a dual-head gamma camera, considering the attenuation factor $e^{-{\mu}x}$ of the conjugate-view method. Material and Method: We developed abdomen and kidney phantoms to perform experiments using Technetium-99m dimercaptosuccinic acid ($^{99m}Tc$-DMSA). The phantom images were obtained by dual-head gamma camera equipped with low-energy, high-resolution, parallel-hole collimators (ICONf, Siemens). The equation was derived from the linear integration of omission ${\gamma}$-ray considering attenuation from the posterior abdomen to the anterior abdomen phantom surface. The program for measurement was developed by Microsoft Visual C++ 6.0. Results : Renal depths of the phantoms were derived from the derived equations and compared with the exact geometrical values. Differences between the measured and the calculated values were the range of 0.1 to 0.7 cm ($0.029{\pm}0.15cm,\;mean{\pm}S.D.$). Conclusion: The present study showed that the use of the derived equations for renal depth measurements, combined with quantitative planar imaging using dual-head gamma camera, could provide more accurate results for individual variation than the conventional method.

• Tuberculosis and Respiratory Diseases
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• v.50 no.4
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• pp.401-408
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• 2001

Background : Perfusion scans are accurate predictors of postoperative lung function. There are few previous studies aimed at predicting the postoperative exercise capacity using the perfusion scanning and those that did reported contradictory results. Method : We prospectively studied the preoperative spirometric, exercise tests and perfusion scans from in 49 consecutive patients who were admitted to Inha University Hospital with surgically resectable lung cancer from Jan. 1998 to Jun. 1999 29 patients who had any condition affecting the lung function and exercise capacity, or refused a surgical resection or a follow-up study were excluded. Spirometric and exercise tests were performed 6 months after operation in 20 patients. Results : The predicted postoperative $FEV_1$, FVC and TLC correlated well with the following corresponding postoperative values : $r_s$ and p value, 0.809 and 0.000 for the $FEV_1$ 0.895 and 0.000 for the FVC ; 0.741 and 0.006 for the TLC, respectively. The measured postoperative exercise values were slightly higher than the postoperative exercise values predicted, $VO_{2max}$ and $Wr_{max}$, were as 112% of $VO_{2max}$ predicted and 119% of $WR_{max}$ predicted. The change in $FEV_1$, FVC and TLC had a weak correlation with the change in $VO_{2max}$ and $WR_{max}$. Conclusion : The perfusion scan was a useful tool for predicting the postoperative exercise capacity. However, they had a tendency to underestimate the exercise capacity, especially in the patients who had a pneumonectomy. A weak correlation between the change in lung function and exercise capacity was observed.

• Tuberculosis and Respiratory Diseases
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• v.43 no.2
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• pp.173-181
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• 1996

Background : Several studies have suggested that impaired mucociliary clearance plays a role in the pathophysiology of bronchial asthma. Cough productive of mucoid sputum is common, and mucous plugs in the airways are frequently observed. These clinical features are in keeping with the histologic lesions of asthma, which involve primarily the epithelial and mucous-producing structures of the conducting airways. Some studies have shown that the mucociliary clearance is impaired in adult asthma, but it has not been studied in childhood asthma. The objectives of this study were to examine whether the mucociliary clearance is impaired in childhood asthma and to estimate the degree of impairment in comparison with that of immotile cilia syndrome. Method : Thirteen children with mild stable asthma and eight patients with immotile cilia syndrome completed this study. Ten healthy children were recruited as a normal control group. The whole-lung mucociliary clearance was measured by the radioaerosol technique. Aerosols, tin colloid particles tagged with the radionuclide technetium-99m($^{99m}Tc$), were generated by means of nebulizer, and inhaled via a mouthpiece. The retention of radioactivity was measured at 30, 60, 90 and 120 minutes by gamma camera, and mucociliary clearance was calculated as percent retention at each time. Results: 1) In each subject, the percent retention decreased variably with the lapse of time. 2) The percent retention of radionuclide decreased at each time in order of normal control, bronchial asthma and immotile cilia syndrome and the percent retention of immotile cilia syndrome was significantly higher than that of normal control at each time(p<0.05). 3) At two hours, the percent retention of bronchial asthma($65.0{\pm}1.8$(SE)%) was significantly higher than that of the normal control($54.4{\pm}3.5%$, p<0.05), and significantly lower than that of immotile cilia syndrome($73.3{\pm}1.4%$, p<0.01). 4) When the percent retention was analyzed according to $PC_{20}$ in the children with bronchial asthma, they had no relationship with each other. Conclusion: Mucociliary clearance in the children with bronchial asthma was significantly lower than normal control. This finding indicates that impaired mucociliary clearance operates in childhood asthma as well, and suggests that it may be one contributing factor in the pathogenesis of asthma. The degree of impairment, however, was not so severe as immotile cilia syndrome.