• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.2
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• pp.87-92
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• 2015

Purpose When the patients takes myocardial perfusion SPECT using $^{201}Tl$, the operator gives the patients an injection of $^{201}Tl$. But the uniformity correction map in SPECT uses $^{99m}Tc$ uniformity correction map. Thus, we want to compare the image quality when it uses $^{99m}Tc$ uniformity correction map and when it uses $^{201}Tl$ uniformity correction map. Materials and Methods Phantom study is performed. We take the data by Asan medical center daily QC condition with flood phantom including $^{201}Tl$ 21.3 kBq/mL. After postprocessing with this data, we analyze CFOV integral uniformity(I.U) and differential uniformity(D.U). And we take the data with Jaszczak ECT Phantom by American college of radiology accreditation program instruction including $^{201}Tl$ 33.4 kBq/mL. After post processing with this data, we analyze spatial Resolution, Integral Uniformity(I.U), coefficient of variation(C.V) and Contrast with Interactive data language program. Results In the flood phantom test, when it uses $^{99m}Tc$ uniformity correction map, Flood I.U is 3.6% and D.U is 3.0%. When it uses $^{201}Tl$ uniformity correction map, Flood I.U is 3.8% and D.U is 2.1%. The flood I.U is worsen about 5%, but the D.U is improved about 30% inversely. In the Jaszczak ECT phantom test, when it uses $^{99m}Tc$ uniformity correction map, SPECT I.U, C.V and contrast is 13.99%, 4.89% and 0.69. When it uses $^{201}Tl$ uniformity correction map, SPECT I.U, C.V and contrast is 11.37%, 4.79% and 0.78. All of data are improved about 18%, 2%, 13% The spatial resolution was no significant changes. Conclusion In the flood phantom test, Flood I.U is worsen but Flood D.U is improved. Therefore, it's uncertain that an image quality is improved with flood phantom test. On the other hand, SPECT I.U, C.V, Contrast are improved about 18%, 2%, 13% in the Jaszczak ECT phantom test. This study has limitations that we can't take all variables into account and study with two phantoms. We need think about things that it has a good effect when doctors decipher the nuclear medicine image and it's possible to improve the image quality using the uniformity correction map of other radionuclides other than $^{99m}Tc$, $^{201}Tl$ when we make other nuclear medicine examinations.

• The Korean Journal of Nuclear Medicine
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• v.33 no.6
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• pp.519-526
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• 1999

Purpose: This study was designed to evaluate the usefulness of a technetium-99m mercaptoacetyltriglycine (Tc-99m MAG3) single photon emission computed tomography (SPECT) performed on transplanted kidney. Materials and Methods: Thirty renal transplant patients were included in this study. Planar scan was performed for 30 minutes using 555 MBq Tc-99m MAG3. A post-voiding SPECT scan was acquired on the third, seventh, fourteenth and twenty eighth day after transplantation. Results: SPECT scan showed interpretable image quality in 26 of 30 patients (86.7%) and 84 in 120 scans (70%). Fourteen of 26 patients with interpretable SPECT image showed decreased or increased radioactivity, but only 5 had abnormal findings on the planar scan. Focal SPECT defects were seen in allografts with normal function (n=3), acute tubular necrosis (n=3), and acute rejection (n=2). The defects are thought to reflect focally underperfused renal parenchyme or, in normal allografts, an artifact from uneven radioactivity distribution. Four of 10 patients with renal arterial variation showed focally decreased radioactivity and SPECT helped guide funker studies that confirmed the exact cause. Five of 10 patients with acute tubular necrosis or acute rejection showed focally decreased radioactivity, but its relation to the patients' clinical course was not clear. Focally increased radioactivity was observed in 5 allografts with normal function and 1 with double ureter in which local clearance delay was observed. Conclusion: Tc-99m MAG3 SPECT renal scan can detect additional focal abnormalities compared to planar scan. Further study is necessary to elucidate the exact clinical significance of the SPECT findings.

• Journal of radiological science and technology
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• v.31 no.3
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• pp.287-292
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• 2008

Position information of radiation interactions in detection material is essential to reconstruct a radiation source image. With most position sensing techniques, the position information of a single interaction inside the detectors can be precisely obtained. Each interaction position of multi-scattering inside scintillators, however, can not be individually measured and only the average of the scattering positions can be obtained, which causes the uncertainty in the measured interaction position. In this paper, the position uncertainties due to the multi-scattering were calculated by Monte Carlo simulation. The simulation model was a 50 by 50 by 5 mm $LaCl_3$(Ce) scintillator(pixel size is 2 by 2 by 5mm) which was utilized for the dual collimation camera. The dual collimation camera uses the information from both photoelectric effect and Compton scattering, and therefore, position uncertainties for both partial and full energy deposition of radiation interactions are calculated. In the case of partial energy deposition(PED), the standard deviations of positions are less than $1{\sim}2mm$, which means the uncertainty caused by multi-scattering is not significant. Because the effect of the multi-scattering with PED is insignificant, the multi-scattering has little effect on the performance of Compton imaging of dual collimation camera. In the case of full energy deposition(FED), however, the standard deviation of the positions is about twice that of the pixel size of the 1stdetector, except for 122keV incident radiations. Therefore, the standard deviations caused by multi-scatterings should be considered in the design of the coded mask of the dual collimation camera to avoid artifact on the reconstructed image. The position uncertainties of the FEDs are much larger than those of the PEDs for all radiation energies and the ratio of PEDs to FEDs increases when the incident radiation energy increases. The position uncertainties of both PEDs and FEDs are dependent on the incident radiation energy.

• Journal of the Korean Society of Radiology
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• v.18 no.1
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• pp.45-52
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• 2024

In this study, an AI-based algorithm was developed to prevent image quality deterioration and reading errors due to patient movement in PET/CT examinations that use radioisotopes in medical institutions to test cancer and other diseases. Using the Mothion Free software developed using, we checked the degree of correction of movement due to breathing, evaluated its usefulness, and conducted a study for clinical application. The experimental method was to use an RPM Phantom to inject the radioisotope 18F-FDG into a vacuum vial and a sphere of a NEMA IEC body Phantom of different sizes, and to produce images by directing the movement of the radioisotope into a moving lesion during respiration. The vacuum vial had different degrees of movement at different positions, and the spheres of the NEMA IEC body Phantom of different sizes produced different sizes of lesions. Through the acquired images, the lesion volume, maximum SUV, and average SUV were each measured to quantitatively evaluate the degree of motion correction by Motion Free. The average SUV of vacuum vial A, with a large degree of movement, was reduced by 23.36 %, and the error rate of vacuum vial B, with a small degree of movement, was reduced by 29.3 %. The average SUV error rate at the sphere 37mm and 22mm of the NEMA IEC body Phantom was reduced by 29.3 % and 26.51 %, respectively. The average error rate of the four measurements from which the error rate was calculated decreased by 30.03 %, indicating a more accurate average SUV value. In this study, only two-dimensional movements could be produced, so in order to obtain more accurate data, a Phantom that can embody the actual breathing movement of the human body was used, and if the diversity of the range of movement was configured, a more accurate evaluation of usability could be made.

• The Korean Journal of Nuclear Medicine
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• v.39 no.6
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• pp.413-420
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• 2005

Purpose: Neuroreceptor PET studies require 60-120 minutes to complete and head motion of the subject during the PET scan increases the uncertainty in measured activity. In this study, we investigated the effects of the data-driven head mutton correction on the evaluation of endogenous dopamine release (DAR) in the striatum during the motor task which might have caused significant head motion artifact. Materials and Methods: $[^{11}C]raclopride$ PET scans on 4 normal volunteers acquired with bolus plus constant infusion protocol were retrospectively analyzed. Following the 50 min resting period, the participants played a video game with a monetary reward for 40 min. Dynamic frames acquired during the equilibrium condition (pre-task: 30-50 min, task: 70-90 min, post-task: 110-120 min) were realigned to the first frame in pre-task condition. Intra-condition registrations between the frames were performed, and average image for each condition was created and registered to the pre-task image (inter-condition registration). Pre-task PET image was then co-registered to own MRI of each participant and transformation parameters were reapplied to the others. Volumes of interest (VOI) for dorsal putamen (PU) and caudate (CA), ventral striatum (VS), and cerebellum were defined on the MRI. Binding potential (BP) was measured and DAR was calculated as the percent change of BP during and after the task. SPM analyses on the BP parametric images were also performed to explore the regional difference in the effects of head motion on BP and DAR estimation. Results: Changes in position and orientation of the striatum during the PET scans were observed before the head motion correction. BP values at pre-task condition were not changed significantly after the intra-condition registration. However, the BP values during and after the task and DAR were significantly changed after the correction. SPM analysis also showed that the extent and significance of the BP differences were significantly changed by the head motion correction and such changes were prominent in periphery of the striatum. Conclusion: The results suggest that misalignment of MRI-based VOI and the striatum in PET images and incorrect DAR estimation due to the head motion during the PET activation study were significant, but could be remedied by the data-driven head motion correction.

• Investigative Magnetic Resonance Imaging
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• v.12 no.2
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• pp.123-130
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• 2008

Purpose : Motion effects in parallel magnetic resonance imaging (MRI) are investigated. Parallel MRI is known to be robust to motion due to its reduced acquisition time. However, if there are some involuntary motions such as heart or respiratory motions involved during the acquisition of the parallel MRI, motion artifacts would be even worse than those in conventional (non-parallel) MRI. In this paper, we defined several types of motions, and their effects in parallel MRI are investigated in comparisons with conventional MRI. Materials and Methods : In order to investigate motion effects in parallel MRI, 5 types of motions are considered. Type-1 and 2 are periodic motions with different amplitudes and periods. Type-3 and 4 are segment-based linear motions, where they are stationary during the segment. Type-5 is a uniform random motion. For the simulation, Cartesian and spiral grid based parallel and non-parallel (conventional) MRI are used. Results : Based on the motions defined, moving artifacts in the parallel and non-parallel MRI are investigated. From the simulation, non-parallel MRI shows smaller root mean square error (RMSE) values than the parallel MRI for the periodic (type-1 and 2) motions. Parallel MRI shows less motion artifacts for linear(type-3 and 4) motions where motions are reduced with shorter acquisition time. Similar motion artifacts are observed for the random motion (type-5). Conclusion : In this paper, we simulate the motion effects in parallel MRI. Parallel MRI is effective in the reduction of motion artifacts when motion is reduced by the shorter acquisition time. However, conventional MRI shows better image quality than the parallel MRI when fast periodic motions are involved.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.7-10
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• 2013

Purpose : This study evaluated the effects of breathing protocols on matching results of PET and CT images using two breathing protocols such as free breathing and acquisition in holding the breathing after the normal expiration in acquiring CT images. Materials and Methods: Whole body FDG PET and CT images of 200 patients (mean age: 58 (range 20~84), 103 males and 97 females) using Discovery VCT (GE Healthcare, Milwaukee, USA). When taking CT images, subjects were asked to breathe freely (free breathing, n=100) or hold the breathing after the normal expiration (Hold, n=100). In the whole body image coronal section where PET and CT were matched, the matched error of the boundary between diaphragm and liver was measured in length. The matched errors were compared according to breathing protocol by age, sex and disease. The verification of statistical significance was made by SPSS 15.0 (SPSS Inc., Chicago, IL, USA) via one way ANOVA. Results: The matched error in all was 0.87 mm. According to breathing protocol, there was no significant difference in matched error as1.01 mm in free breathing and as 0.73 mm in hold breathing (p=.688). The matched error according to sex did not show significant difference as 1.08 mm of males, and 0.93 mm of females in free breathing (p=.517). In hold breathing, there was no significant difference as 0.79 mm of males and 0.66 mm of females (p=.738). There was no significant difference in matched error by age between free breathing and hold breathing (free breathing (p=.728), hold (p=.465). There was no significant difference in matched error by disease between free breathing and hold breathing (free breathing (p=.197), hold (p=.518) Conclusion: The difference in matched error between free breathing and hold breathing was less than 5 mm at 99%. There was no statistically significant difference in matched error by breathing protocol, age and disease. It was proved that there was no difference in matched error between PET and CT images according to breathing protocol during PET/CT scan.

• Investigative Magnetic Resonance Imaging
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• v.14 no.1
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• pp.31-40
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• 2010

Purpose : To compare the relative values of various fast breath-hold imaging sequences for superparamagnetic iron-oxide (SPIO)-enhanced hepatic MRI for the assessment of solid focal lesions with a 3T MRI unit. Materials and Methods : 102 consecutive patients with one or more solid malignant hepatic lesions were evaluated by spoiled gradient echo (GRE) sequences with three different echo times (2.4 msec [GRE_2.4], 5.8 msec [GRE_5.8], and 10 msec [GRE_10]) for $T2^*$-weighted imaging in addition to T2-weighted turbo spin echo (TSE) sequence following intravenous SPIO injection. Image qualities of the hepatic contour, vascular landmarks and artifacts were rated by two independent readers using a four-point scale. For quantitative analysis, contrast-to-noise ratio (CNR) was measured in 170 solid focal lesions larger than 1 cm (107 hepatocellular carcinomas, nine cholangiocarcinomas and 54 metastases). Results : GRE_5.8 showed the highest mean points for hepatic contour, vascular anatomy and imaging artifact presence among all of the subjected sequences (p<0.001) and was comparable (p=0.414) with GRE_10 with regard to lesion conspicuity. The mean CNRs were significantly higher (p<0.001) in the following order: GRE_10 ($24.4{\pm}14.5$), GRE_5.8 ($14.8{\pm}9.4$), TSE ($9.7{\pm}6.3$), and GRE_2.4 ($7.9{\pm}6.4$). The mean CNRs of CCCs and metastases were higher than those of HCCs for all imaging sequences (p<0.05). Conclusion : Regarding overall performances, GRE using a moderate echo time of 5.8 msec can provide the most reliable data among the various fast breath-hold SPIO-enhanced hepatic MRI sequences at 3T unit despite the lower CNR of GRE_5.8 compared to that of GRE_10.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.127-133
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• 2014

Purpose: Low dose of PET/CT is important because of Patient's X-ray exposure. The aim of this study was to evaluate the effectiveness of low-dose PET/ CT image through the CTAC and QAC of patient study and phantom study. Materials and Methods: We used the discovery 710 PET/CT (GE). We used the NEMA IEC body phantom for evaluating the PET data corrected by ultra-low dose CT attenuation correction method and NU2-94 phantom for uniformity. After injection of 70.78 MBq and 22.2 MBq of 18 F-FDG were done to each of phantom, PET/CT scans were obtained. PET data were reconstructed by using of CTAC of which dose was for the diagnosis CT and Q. AC of which was only for attenuation correction. Quantitative analysis was performed by use of horizontal profile and vertical profile. Reference data which were corrected by CTAC were compared to PET data which was corrected by the ultra-low dose. The relative error was assessed. Patients with over weighted and normal weight also underwent a PET/CT scans according to low dose protocol and standard dose protocol. Relative error and signal to noise ratio of SUV were analyzed. Results: In the results of phantom test, phantom PET data were corrected by CTAC and Q.AC and they were compared each other. The relative error of Q.AC profile was been calculated, and it was shown in graph. In patient studies, PET data for overweight patient and normal weight patient were reconstructed by CTAC and Q.AC under routine dose and ultra-low dose. When routine dose was used, the relative error was small. When high dose was used, the result of overweight patient was effectively corrected by Q.AC. Conclusion: In phantom study, CTAC method with 80 kVp and 10 mA was resulted in bead hardening artifact. PET data corrected by ultra- low dose CTAC was not quantified, but those by the same dose were quantified properly. In patients' cases, PET data of over weighted patient could be quantified by Q.AC method. Its relative difference was not significant. Q.AC method was proper attenuation correction method when ultra-low dose was used. As a result, it is expected that Q.AC is a good method in order to reduce patient's exposure dose.

• Journal of Gastric Cancer
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• v.6 no.4
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• pp.263-269
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• 2006

Purpose: The aim of this study was to investigate the causes of under-staging in patients with advanced gastric cancer that was proven to be unresectable after a laparotomy. Materials and Methods: We retrospectively analyzed 25 gastric cancer patients who had undergone a diagnostic laparotomy between 2001 and 2005. For the preoperative evaluation, spiral CT and multidetector-row CT were performed. We analyzed the clinicopathologic features of patients and compared the image findings and the results of surgery. The causes of under-staging were divided into 3 groups; patient factor, CT factor, and interpretation factor. Results: Grossly, there were 12 cases of Borrmann type-III tumors and 13 cases of Borrmann type-IV tumors. The most frequent histologic type was poorly differentiated adenocarcinomas (8 cases) and signet ring cell carcinomas (7 cases). There were 13 cases of adjacent organ invasion, and the pancreas was the most frequently invaded organ (9 cases). There were 17 cases of peritoneal metastasis, and 3 cases of distant lymph node metastasis. For the cause of under-staging, there were four cases of patient factor, 19 cases of interpretation factor, and 9 cases of CT factor. In three cases, the cause of under-staging could not be identified. Conclusion: CT interpretation factor was the most frequent cause of under-staging in the preoperative diagnosis with gastric cancer patients. Therefore, more cautious CT interpretation is necessary to avoid unnecessary laparotomies in gastric cancer patients.