• Journal of Yeungnam Medical Science
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• v.16 no.2
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• pp.237-243
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• 1999

We conducted this study to find the optimal correction factor(${\alpha}$) of Lassen's linearization algorithm which has been applied for correction of flow-limited uptake at a high flow range in $^{99m}Tc$ d,l-hexamethylpropy leneamine oxime(HMPAO) and $^{99m}Tc$ ethyl cysteinate dimer(ECD). Ten patients with chronic cerebral infarction were involved in this study. We obtained the corrected $^{99m}Tc$ HMPAO and $^{99m}Tc$-ECD brain SPECT(single photon emission computed tomography) using the algorithm with ${\alpha}$ values that varied from 0.1 to 10 and compared the results with regional cerebral blood flow determined by positron emission tomography (PET-rCBF). The multi-modal volume registration by maximization of mutual information was used for matching between PET-rCBF and SPECT images. The highest correlation coefficient between $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD brain uptake and PET-rCBF was revealed at ${\alpha}$ 1.4 and 2.1, respectively. We concluded that the ${\alpha}$ values of Lassen's linearization algorithm for $^{99m}Tc$-HMPAO and $^{99m}Tc$-ECD brain SPECT images were 1.4 and 2.1, respectively to indicate cerebral blood flow with comparison of PET-rCBF.

• Journal of the Korean Physical Society
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• v.73 no.9
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• pp.1393-1398
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• 2018

In conventional single-photon emission computed tomography (SPECT), only the photoelectric events in the detectors are used for image reconstruction. However, if the $^{131}I$ isotope, which emits high-energy radiations (364, 637, and 723 keV), is used in nuclear medicine, both photoelectric and Compton scattering events can be used for image reconstruction. The purpose of our work is to perform simulations for Compton SPECT by using the Geant4 application for tomographic emission (GATE). The performance of Compton SPECT is evaluated and compared with that of conventional SPECT. The Compton SPECT unit has an area of $12cm{\times}12cm$ with four gantry heads. Each head is composed of a 2-cm tungsten collimator and a $40{\times}40$ array of CdZnTe (CZT) crystals with a $3{\times}3mm^2$ area and a 6-mm thickness. Compton SPECT can use not only the photoelectric effect but also the Compton scattering effect for image reconstruction. The correct sequential order of the interactions used for image reconstruction is determined using the angular resolution measurement (ARM) method and the energies deposited in each detector. In all the results of simulations using spherical volume sources of various diameters, the reconstructed images of Compton SPECT show higher signal-to-noise ratios (SNRs) without degradation of the image resolution when compared to those of conventional SPECT because the effective count for image reconstruction is higher. For a Derenzo-like phantom, the reconstructed images for different modalities are compared by visual inspection and by using their projected histograms in the X-direction of the reconstructed images.

• Nuclear Engineering and Technology
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• v.54 no.8
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• pp.3006-3016
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• 2022

In this study, the images of specific prompt gamma (PG)-rays of 719 keV emitted from proton-boron reactions were analyzed using single-photon emission computed tomography (SPECT). Quantitative evaluation of the images verified the detection of anatomical changes in tumors, one of the important factors in daily adaptive proton therapy (DAPT) and verified the possibility of application of the PG-ray images to DAPT. Six scenarios were considered based on various sizes and locations compared to the reference virtual tumor to observe the anatomical alterations in the virtual tumor. Subsequently, PG-rays SPECT images were acquired using the modified ordered subset expectation-maximization algorithm, and these were evaluated using quantitative analysis methods. The results confirmed that the pixel range and location of the highest value of the normalized pixel in the PG-rays SPECT image profile changed according to the size and location of the virtual tumor. Moreover, the alterations in the virtual tumor size and location in the PG-rays SPECT images were similar to the true size and location alterations set in the phantom. Based on the above results, the tumor anatomical alterations in DAPT could be adequately detected and verified through SPECT imaging using the 719 keV PG-rays acquired during treatment.

• Journal of Korean Neurosurgical Society
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• v.59 no.2
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• pp.117-121
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• 2016

Objective : Hemorrhagic moyamoya disease (hMMD) is associated with a poor clinical course. Furthermore, poorer clinical outcomes occur in cases of recurrent bleeding. However, the effect of hemodynamic insufficiency on rebleeding risk has not been investigated yet. This study evaluated the prognostic implications of the perfusion status during the clinical course of adult hMMD. Methods : This retrospective study enrolled 52 adult hMMD patients between April 1995 and October 2010 from a single institute. Demographic data, clinical and radiologic characteristics, including hemodynamic status using single photon emission computed tomography (SPECT), and follow up data were obtained via a retrospective review of medical charts and imaging. Statistical analyses were performed to explore potential prognostic factors. Results : Hemodynamic abnormality was identified in 44 (84.6%) patients. Subsequent revascularization surgery was performed in 22 (42.3%) patients. During a 58-month (median, range 3-160) follow-up assessment period, 17 showed subsequent stroke (hemorrhagic n=12, ischemic n=5, Actuarial stroke rate $5.8{\pm}1.4%/year$). Recurrent hemorrhage was associated with decreased basal perfusion (HR 19.872; 95% CI=1.196-294.117) and omission of revascularization (10.218; 95%; CI=1.532-68.136). Conclusion : Decreased basal perfusion seems to be associated with recurrent bleeding. Revascularization might prevent recurrent stroke in hMMD by rectifying the perfusion abnormality. A larger-sized, controlled study is required to address this issue.

• The Journal of the Korea Contents Association
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• v.9 no.12
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• pp.322-331
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• 2009

In clinical SPECT, FWHM provides quality information of the images obtained under different observing conditions. Therefore, the purpose of this study was to determine the optimum cut off level with comparison of FWHM according to cut off levels in each filter - Band limited, Sheep-Logan, Hanning, Hamming, Low pass cosine, Parazen and Butterworth filter in a SPECT camera. I recorded images along the X, Y, Z-axis with 99mTcO4 point source and measured FWHM with profile curves. In conclusion, all filters showed the longest figures of FWHM with cut off level 0.4, which has the worst image resolution. The images with cut off level 0.7 showed best image resolution. The shortest average of FWHM in MS2 was $11.07\pm0.07mm$ using the Butterworth filter, in MS3 it was $8.44\pm0.19mm$ through using the Hanning filter.

• Progress in Medical Physics
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• v.28 no.3
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• pp.77-82
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• 2017

We proposed the objective ROC analysis method based on the setting of threshold value for evaluation of single photon emission computed tomography (SPECT) image. This proposed ROC analysis method uses the quantification computational threshold value to each signal on the SPECT image. The SPECT images for this study were acquired by using Monte Carlo n-particle extended simulation code (MCNPX, Ver. 2.6.0, Los Alamos National Laboratory, USA). The basic SPECT detectors and specific water phantom were realized in the simulation, and we could get the simulation results by the simulation operation. We tried to analyze the reconstructed images using threshold value application based objective ROC method. We can get the accuracy information of reconstructed region in the image. This proposed ROC technique can be helpful when we have to evaluate the weak signal for the NM image. In this study, the proposed threshold value based computational ROC analysis method can provide better objectivity than the conventional ROC analysis method.

• Journal of Korean Neurosurgical Society
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• v.40 no.6
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• pp.434-440
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• 2006

Objective : The purpose of this study is to examine the influence of cranioplasty on dynamics of cerebral blood flow[CBF] and cerebrovascular reserve capacity[CVRC], and to investigate the usefulness of single photon emission computed tomography [SPECT] as a prognostic factor for neurological improvement after cranioplasty. Methods : Between March 2003 and December 2005, a prospective study was performed on 24 patients who had undergone total 25 cranioplasty operations. Cerebral blood flow velocities in the middle cerebral artery[MCA] and internal carotid artery[ICA] were obtained by transcranial Doppler ultrasonography[TCD]. The CVRC was assessed by SPECT in the natural state and after stimulation with 1g of acetazolamide. Neurological improvement after cranioplasty was compared between patients who showed hyperactivity to acetazolamide-activated SPECT [Group 1, n=7] and hypoactivity to acetazolamide-activated SPECT [Group 2, n=17]. These measurements were obtained two weeks prior to and two weeks after cranioplasty. Results : The blood flow velocities at the opposite site to the cranioplasty as well as at the cranioplasty site were significantly increased [P<0.05]. Compared with Group 2, there was significant increase in CBF and neurological improvement after cranioplasty in Group 1. Conclusion : Among patients with surgical bony defects, the patients who had normal reactivity of the CVRC showed a significant increase in CBF and neurological improvement after cranioplasty. The authors suggest that CVRC measurement prior to surgery may be an important prognostic factor for neurological improvement after cranioplasty.

• Clinical and Experimental Pediatrics
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• v.53 no.4
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• pp.603-606
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• 2010

Paraneoplastic limbic encephalitis, a remote effect of cancer without nervous system metastasis, is rare, especially in childhood. Here, we report a case of paraneoplastic limbic encephalitis associated with an ovarian mature teratoma in an adolescent girl. The 15-year-old girl developed neuropsychiatric symptoms, memory loss, seizures, and unconsciousness. Cerebrospinal fluid analysis and brain magnetic resonance imaging (MRI) findings were normal, while single photon emission computed tomography imaging showed hypoperfusion in both temporal lobes. Ultrasound and MRI of the abdomen revealed a left ovarian cystic mass. The patient experienced a significant recovery of cognitive function after surgical resection of the tumor, which was pathologically identified as a mature ovarian teratoma, and treatment with intravenous immunoglobulin.

• The Korean Journal of Nuclear Medicine
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• v.25 no.1
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• pp.68-75
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• 1991

The value of $^{99}Tc-RBC$ scintigraphy and SPECT in the diagnosis of hepatic hemangioma was evaluated in 27 patients with 38 hemangiomas and 13 patients with 15 nonhemangiomas. Twenty four (63.2%) of 38 hemangiomas were detected by planar delayed RBC imaging, whereas 30 (78.9%) hemangiomas were detected by the delayed RBC SPECT. Increase in sensitivity was noted in nodules less than 2 cm in diameter. The smallest hemangioma shown by delayed RBC SPECT was 0.9 cm in diameter. All of nonhemangiomatous lesions show normal or decreased activity in delayed blood pool images. We concluded that $^{99m}Tc-RBC$ SPECT is an accurate method for the detection of hepatic hemangioma and is more sensitive than planar imaging in depicting small lesions.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.1-14
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• 1996

Since the publication of the first bone scintiscans in 1962 three decades have elapsed. The bone scan has made great strides during this period, becoming one of the most commonly used nuclear imaging tests. In spite of the progress, however, the specificity of bone scan has remained relatively low. As the result it is a common practice to seek additional information from radiograph, CT scan and MR image, which is euphemistically termed as "image fusion or co-location." The basic reason is the inapplicability of the classical piecemeal analysis to interpreting planar and SPECT bone scans. Such analysis has its base on the observation of elemental features of morphology, which include the size, shape, contour, location, topography and internal architecture. The physiochemical profile may well also be included. Understandably, however, the miniatured images of the planar bone scan cannot provide these features in acceptable detail and the same holds true even with SPECT Images which are but sliced views of the reconstructed planar scans. Fortunately pinhole scanning has the capacity to portray both the morphological and chemical profiles of bone and joint diseases in greater detail through true magnification. The magnitude of pinhole scan resolution is practically comparable to that of radiography as far as gross anatomy is concerned. Thus, we feel strongly that pinhole scanning is a potential breakthrough of the long-lamented low specificity of bone scan. This presentation will discuss the fun-damentals, advantages and disadvantages and the most recent advances of pinhole scanning. It high-lights the actual clinical applications of pinhole scanning in relation to the diagnosis of infective and inflammatory diseases of bone and joint.