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Relationship between Brain Perfusion SPECT and MMSE Score in Dementia of Alzheimer's Type: A statistical Parametric Mapping Analysis (알쯔하이머형 치매환자에서 SPM 방법을 이용한 뇌 관류 SPECT와 정신-인지기능 수행성능의 상관)

  • Kang, Hye-Jin;Lee, Dong-Soo;Kang, Eun-Joo;Lee, Jae-Sung;Yeo, Seong-Seok;Kim, Jin-Yeong;Lee, Dong-Woo;Cho, Maeng-Je;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.2
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    • pp.91-101
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    • 2002
  • Purpose : The aim of this study was to identify the brain areas in which reductions of regional cerebral blood flow (rCBF) were correlated with decline of general mental function, measured by Mini-Mental State Examination (MMSE). Materials and Methods : Tc-99m HMPAO brain SPECT was peformed in 9 probable AD patients at the initial and follow-up periods of 1.8 years (average) after the first study. MMSE scores were also measured in both occasions. The mean MMSE score of the initial study 16.4 (range: 5 - 24) and the mean MMSE score of the follow-up was 8.1 (range: 0 - 17). Each SPECT image was normalized to the cerebellar activity and a correlation analysis was peformed between the level of rCBF in AD patients and the MMSE scores by voxel-based analysis using SPM99 software. Results : Significant correlation was found between the blood-flow decrease in left inferior prefrontal region (BA 47) and left middle temporal legion (BA 21) and the MMSE score changes. Additional areas such as anterior and posterior cingulate cortices, precuneus, and bilateral superior and middle prefrontal regions showed the similar trends. Conclusions : A relationship was found between reduction of regional cerebral blood flow in left prefrontal and temporal areas and decline of cognitive function in Alzheimer's disease(AD) patients. This voxel-based analysis is useful in evaluating the progress of cognitive function in Alzheimer's disease.

Functional Brain Mapping Using $H_2^{15}O$ Positron Emission Tomography ( I ): Statistical Parametric Mapping Method ($H_2^{15}O$ 양전자단층촬영술을 이용한 뇌기능 지도 작성(I): 통계적 파라메터 지도작성법)

  • Lee, Dong-Soo;Lee, Jae-Sung;Kim, Kyeong-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.225-237
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    • 1998
  • Purpose: We investigated the statistical methods to compose the functional brain map of human working memory and the principal factors that have an effect on the methods for localization. Materials and Methods: Repeated PET scans with successive four tasks, which consist of one control and three different activation tasks, were performed on six right-handed normal volunteers for 2 minutes after bolus injections of 925 MBq $H_2^{15}O$ at the intervals of 30 minutes. Image data were analyzed using SPM96 (Statistical Parametric Mapping) implemented with Matlab (Mathworks Inc., U.S.A.). Images from the same subject were spatially registered and were normalized using linear and nonlinear transformation methods. Significant difference between control and each activation state was estimated at every voxel based on the general linear model. Differences of global counts were removed using analysis of covariance (ANCOVA) with global activity as covariate. Using the mean and variance for each condition which was adjusted using ANCOVA, t-statistics was performed on every voxel To interpret the results more easily, t-values were transformed to the standard Gaussian distribution (Z-score). Results: All the subjects carried out the activation and control tests successfully. Average rate of correct answers was 95%. The numbers of activated blobs were 4 for verbal memory I, 9 for verbal memory II, 9 for visual memory, and 6 for conjunctive activation of these three tasks. The verbal working memory activates predominantly left-sided structures, and the visual memory activates the right hemisphere. Conclusion: We conclude that rCBF PET imaging and statistical parametric mapping method were useful in the localization of the brain regions for verbal and visual working memory.

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Functional Brain Mapping Using $H_2^{15}O$ Positron Emission Tomography ( II ): Mapping of Human Working Memory ($H_2^{15}O$ 양전자단층촬영술을 이용한 뇌기능 지도 작성(II): 작업 기억의 지도 작성)

  • Lee, Jae-Sung;Lee, Dong-Soo;Lee, Sang-Kun;Nam, Hyun-Woo;Kim, Seok-Ki;Park, Kwang-Suk;Jeong, Jae-Min;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.32 no.3
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    • pp.238-249
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    • 1998
  • Purpose: To localize and compare the neural basis of verbal and visual human working memory, we performed functional activation study using $H_2^{15}O$ PET. Materials and Methods: Repeated $H_2^{15}O$ PET scans with one control and three different activation tasks were performed on six right-handed normal volunteers. Each activation task was composed of 13 match-ing trials. On each trial, four targets, a fixation dot and a probe were presented sequentially and subject's task was to press a response button to indicate whether or not the probe was one of the previous targets. Short meaningful Korean words, simple drawings and monochromic pictures of human faces were used as matching objects for verbal or visual memory. All the images were spatially normalized and the differences between control and activation states were statistically analyzed using SPM96. Results: Statistical analysis of verbal memory activation with short words showed activation in the left Broca's area, promoter cortex, cerebellum and right cingulate gyrus. In verbal memory with simple drawings, activation was shown in the larger regions including where activated with short words and left superior temporal cortex, basal ganglia, thalamus, prefrontal cortex, anterior portion of right superior temporal gyrus and right infero-lateral frontal cortex. On the other hand, the visual memory task activated predominantly right-sided structures, especially inferior frontal cortex, supplementary motor cortex and superior parietal cortex. Conclusion: The results are consistent with the hypothesis of the laterality and dissociation of the verbal and visual working memory from the invasive electrophysiological studies and emphasize the pivotal role of frontal cortex and cingulate gyrus in working memory system.

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A Computer Simulation for Small Animal Iodine-125 SPECT Development (소동물 Iodine-125 SPECT 개발을 위한 컴퓨터 시뮬레이션)

  • Jung, Jin-Ho;Choi, Yong;Chung, Yong-Hyun;Song, Tae-Yong;Jeong, Myung-Hwan;Hong, Key-Jo;Min, Byung-Jun;Choe, Yearn-Seong;Lee, Kyung-Han;Kim, Byung-Tae
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.1
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    • pp.74-84
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    • 2004
  • Purpose: Since I-125 emits low energy (27-35 keV) radiation, thinner crystal and collimator could be employed and, hence, it is favorable to obtain high quality images. The purpose of this study was to derive the optimized parameters of I-125 SPECT using a new simulation tool, GATE (Geant4 Application for Tomographic Emission). Materials and Methods: To validate the simulation method, gamma camera developed by Weisenberger et al. was modeled. Nal(T1) plate crystal was used and its thickness was determined by calculating detection efficiency. Spatial resolution and sensitivity curves were estimated by changing variable parameters for parallel-hole and pinhole collimator. Peformances of I-125 SPECT equipped with the optimal collimator were also estimated. Results: in the validation study, simulations were found to agree well with experimental measurements in spatial resolution (4%) and sensitivity (3%). In order to acquire 98% gamma ray detection efficiency, Nal(T1) thickness was determined to be 1 mm. Hole diameter (mm), length (mm) and shape were chosen to be 0.2:5:square and 0.5:10:hexagonal for high resolution (HR) and general purpose (GP) parallel-hole collimator, respectively. Hole diameter, channel height and acceptance angle of pinhole (PH) collimator were determined to be 0.25 mm, 0.1 mm and 90 degree. The spatial resolutions of reconstructed image of the I-125 SPECT employing HR:GP:PH were 1.2:1.7:0.8 mm. The sensitivities of HR:GP:PH were 39.7:71.9:5.5 cps/MBq. Conclusion: The optimal crystal and collimator parameters for I-125 Imaging were derived by simulation using GATE. The results indicate that excellent resolution and sensitivity imaging is feasible using I-125 SPECT.

Assessment of Hydroureteronephrosis in Children Using Diuretic Radionuclide Ureterography (동위원소 이뇨 요관그람을 이용한 소아 요관폐쇄의 평가)

  • Kim, Jong-Ho;Lee, Dong-Soo;Kwark, Cheol-Eun;Lee, Kyung-Han;Choi, Chang-Woon;Chung, June-Key;Lee, Myung-Chul;Koh, Chang-Soon;Choi, Yong;Choi, Hwang
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.1
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    • pp.75-84
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    • 1994
  • The need for assessment of ureteric function in the patient with an obviousely dilated ureter has increased particularly with the added spectrum of asymptomatic patients presenting with hydrone-phrosis and hydroureter on antenatal and perinatal ultrasound. To assess the influence of ureteral status on kidney washout during $^{99m}Tc$-DTPA diuretic renography, ureteral images were reviewed in 80 children referred for hydronephrosis. A scintigraphically abnormal ureter was defined as an intense and continuous image of > 10 min during diuretic renography. Out of them, a total of 16 nephroureteral systems in 12 children with scintigraphically abnormal ureter were analyzed. A diuretic washout index using response half time (t1/2) by linear fitting after lasix injection, was determined on renal (Kt1/2) and ureteral (Ut1/2) curves (diuretic renogram vs. diuretic ureterogram). Diuretic ureterogram curve patterns corresponding to normal (type I), obstructive (II) and non-obstructive (III) cases were described. Compared with X-ray data, diuretic renography was highly sensitive (88%) and specific (99%) for detecting any ureteral abnormality. Despite an obstructive Kt1/2 (>20 min), no patient with an abnormal ureter underwent therapy at the ureteropelvic junction because the hydronephrosis regressed after surgery at the lower level. Our data indicate that the abnormal ureter findings during diuretic renography have to be recognized before therapy for children with hydeonephrosis.

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Diagnostic Accuracy of Rest T1-201/Stress Tc-99m-MIBI Myocardial SPECT in the Diagnosis of Coronary Artery Disease (휴식 T1-201/부하 Tc-99m MIBI 심근 SPECT의 관상동맥질환 진단 정확성)

  • Yeo, Jeong-Seok;Lee, Dong-Soo;Kang, Keon-Wook;Sohn, Dae-Won;Oh, Byung-Hee;Lee, Myung-Mook;Chung, June-Key;Park, Young-Bae;Lee, Myung-Chul;Seo, Jung-Don;Lee, Young-Woo;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.1
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    • pp.112-117
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    • 1996
  • Objective: Standard stress/rest Tc-99m MIBI and T1-201 myocardial perfusion study have some limitations such as stress/rest image overlap for Tc-99m-MIBI, low energy for T1-201 and long period of study time for two separate studies. Separate acquisition rest T1-201/stress Tc-99m MIBI dual isotope study is a potentially efficient myocardial perfusion imaging protocol that combines the high resolution of Tc-99m for stress perfusion assessment and T1-201 for viability assessment. This study assessed the usefulness and diagnostic accuracy for this new approach. Methods: We tried to evaluate sensitivity and specificity of dual isotope separate acquisition protocol in 67 patients. Immediately after resting T1-201 SPECT data was acquired, dipyridamole stress Tc-99m MIBI myocardial perfusion study was performed. Visual analysis was carried out qualitatively with 0 to 3 scoring system for 17 segments of left ventricle in the reconstructed horizontal long axis and short axis slices. Results: Total study was completed within 3 hours. In angiographic correlation, dual isotope SPECT demonstrated high sensitivity(85%) and in a small group of patients, high specificity was also observed (100%). Conclusion: Combined thallium-201/stress Tc-99m MIBI SPECT displayed similiar diagnostic accuracy to protocol using stress/rest Tc-99m MIBI SPECT. This protocol was completed in shorter period than the previous protocols and therefore enhance laboratory throughput and patients convenience.

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$^{99m}Tc$ Labeling Kit Preparation and Characteristics of Anti-NCA-95 Monoclonal Antibody (항 NCA-95 단일클론항체의 $^{99m}Tc$표지 키트 제조 및 특성 연구)

  • Hong, Mee-Kyoung;Jeong, Jae-Min;Chung, June-Key;Choi, Seok-Rye;Kim, Chae-Kyun;Lee, Yong-Jin;Lee, Dong-Soo;Lee, Myung-Chul;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.30 no.4
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    • pp.541-547
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    • 1996
  • The previous monoclonal antibody labeling method for bone marrow immunoscintigrapy was complicated and laborious for clinical application. Also it showed a relatively low labeling efficiency. To improve this procedure, we compared several direct labeling methods of $^{99m}Tc$. 1) The labeling efficiency in the method using gluconate as a transchelator was low (40-70%), but immunoscintigraphy using this radiotracer produced a clear image. 2) To improve labeling efficiency, ${\beta}$-mercaptoethanol was removed after reduction. The labeling efficiency was improved up to 70-80%, but the radioactivity of the blood pool was high. 3) The higest labeling efficiency (>90%) and best quality images could be obtained by using MDP as a transchelating agent. It did not require additional procedures for separation of labeled antibodies. The immunoreactivity of this antibody was 60%. Residual MDP which can be taken up by the bone could be removed by PD-10 column. The reduced antibodies were stable with a high labeling efficiency (>90%) for up to 47 days by deep freezing. We concluded that the improved procedure for $^{99m}Tc$ labeling of anti-NCA-95 monoclonal antibody using MDP as a transchelating agent will be a simple and useful method for clinical application.

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Interobserver Reproducibility of Segmental Scoring of $^{99m}Tc$-MIBI Myocardial SPECT ($^{99m}Tc$-MIBI 심근 SPECT의 분절 육안 분석시 판독자간의 일치도)

  • Yeo, Jeong-Seok;Lee, Dong-Soo;Lee, Kyung-Han;Kim, Jong-Ho;Shon, Kyung-Soo;Cho, Sung-Wook;Kwark, Cheol-Eun;Chung, June-Key;Lee, Myung-Chul;Seo, Jeong-Don;Koh, Chang-Soon
    • The Korean Journal of Nuclear Medicine
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    • v.28 no.3
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    • pp.317-325
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    • 1994
  • The accuracy of dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial imaging for detection of ischemia depends on reproducible image interpretation. To evaluate the reproducibility of visual assessment, agreement in interpretation among two independent observers, blind-ed to clinical data, was evaluated in SPECT images of 131 patients (94 males, 38 females; mean age $58{\pm}7yr$) with suspected coronary artery disease who underwent both dipyridamole stress/rest $^{99m}Tc$-MIBI myocardial SPECT and coronary angiography. The left ventricle was divided into twenty-nine segments in stress and rest SPECT images and each segment was visually graded according to a five-point scale (segmental score : 0=normal, 1=equivocal, 2=mild decrease, 3=severe decrease and 4=absent uptake). Overall concordance of segmental scoring between the two observers was 80%. The Pear-son's correlation coefficient (r) of the segmental scores for stress and rest images were 0.67 and 0.65, respectively, while the difference in score between the two images showed a correlation of 0.45 (all p<0.001). Agreement between two observers in final SPECT diagnosis as absence or presence of disease was 93%. The degree of agreement in segmental scoring showed no difference between patients with or without agreement as to the presence of disease. Therefore it appeared that cases with inconcordant diagnosis between the 2 observers were mainly due to a difference in individual threshold for interpretating the significance of a particular decreased uptake area rather than to a difference in perceiving the degree of the hypoactivity Thus, establishment of individual optimum thresholds in visual interpretation of myocardial SPECT may be helpful to improve reproducibility and accuracy of scan diagnosis.

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The Usefulness of F-18 FDG Whole Body PET in the Evaluation of Postoperative Recurrence of Cancer (수술 후 암 재발 판정에 있어서 전신 F-18 FDG-PET의 유용성)

  • Kang, Won-Jun;So, Young;Jeong, Jae-Min;Kwark, Cheol-Eun;Lee, Dong-Soo;Kang, Soon-Bem;Jung, Hee-Won;Kim, Kwang-Hyun;Park, Jae-Gahb;Lee, Myung-Chul;Koh, Chang-Soon;Chung, June-Key
    • The Korean Journal of Nuclear Medicine
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    • v.31 no.3
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    • pp.372-380
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    • 1997
  • The purpose of this study was to evaluate the usefulness of whole body F-18 FDG PET scan for detecting postoperative recurrence of cancer. One hundred four cancer patients after operation were enrolled(14 brain tumor, 15 head and neck cancer, 23 gynecologic cancer, 16 gastrointestinal cancer, 16 thyroid cancer, and 20 other cancers). Besides conventional images(CI) including CT and MRI, F-18 FDG PET scan was obtained on ECAT EXACT 47 scanner(Siemens-CTI), beginning 60 minutes after injection of 370MBq(10mCi) of F-18 FDG. Regional scan was also obtained with emission image. Transmission images using Ge-68 were carried out for attenuation correction in both whole body and regional images. Findings of PET, and CI were confirmed by pathology or clinical follow up. The sensitivity and specificity of PET for detecting recurrence were 94% and 92%, respectively. Contrarily, the sensitivity and specificity of CI were 78% and 68%. CI results were negative and PET results were positive in 11 cases. The biopsy or clinical follow-up of those cases confirmed recurrence of tumor. False negative cases of CI were frequent in patients with gynecologic cancers. Also we measured the serum concentration of tumor markers in patients with gynecologic cancer(CA125), thyroid cancer(thyroglobulin), and colorectal cancer(CEA). The sensitivity and specificity of tumor markers were 71% and 84%, respectively, We conclude that F-18 FDG PET can be used valuably in detecting recurrent foci of a wide variety of malignancy compared to conventional diagnostic methods.

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Personalized Exhibition Booth Recommendation Methodology Using Sequential Association Rule (순차 연관 규칙을 이용한 개인화된 전시 부스 추천 방법)

  • Moon, Hyun-Sil;Jung, Min-Kyu;Kim, Jae-Kyeong;Kim, Hyea-Kyeong
    • Journal of Intelligence and Information Systems
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    • v.16 no.4
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    • pp.195-211
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    • 2010
  • An exhibition is defined as market events for specific duration to present exhibitors' main product range to either business or private visitors, and it also plays a key role as effective marketing channels. Especially, as the effect of the opinions of the visitors after the exhibition impacts directly on sales or the image of companies, exhibition organizers must consider various needs of visitors. To meet needs of visitors, ubiquitous technologies have been applied in some exhibitions. However, despite of the development of the ubiquitous technologies, their services cannot always reflect visitors' preferences as they only generate information when visitors request. As a result, they have reached their limit to meet needs of visitors, which consequently might lead them to loss of marketing opportunity. Recommendation systems can be the right type to overcome these limitations. They can recommend the booths to coincide with visitors' preferences, so that they help visitors who are in difficulty for choices in exhibition environment. One of the most successful and widely used technologies for building recommender systems is called Collaborative Filtering. Traditional recommender systems, however, only use neighbors' evaluations or behaviors for a personalized prediction. Therefore, they can not reflect visitors' dynamic preference, and also lack of accuracy in exhibition environment. Although there is much useful information to infer visitors' preference in ubiquitous environment (e.g., visitors' current location, booth visit path, and so on), they use only limited information for recommendation. In this study, we propose a booth recommendation methodology using Sequential Association Rule which considers the sequence of visiting. Recent studies of Sequential Association Rule use the constraints to improve the performance. However, since traditional Sequential Association Rule considers the whole rules to recommendation, they have a scalability problem when they are adapted to a large exhibition scale. To solve this problem, our methodology composes the confidence database before recommendation process. To compose the confidence database, we first search preceding rules which have the frequency above threshold. Next, we compute the confidences of each preceding rules to each booth which is not contained in preceding rules. Therefore, the confidence database has two kinds of information which are preceding rules and their confidence to each booth. In recommendation process, we just generate preceding rules of the target visitors based on the records of the visits, and recommend booths according to the confidence database. Throughout these steps, we expect reduction of time spent on recommendation process. To evaluate proposed methodology, we use real booth visit records which are collected by RFID technology in IT exhibition. Booth visit records also contain the visit sequence of each visitor. We compare the performance of proposed methodology with traditional Collaborative Filtering system. As a result, our proposed methodology generally shows higher performance than traditional Collaborative Filtering. We can also see some features of it in experimental results. First, it shows the highest performance at one booth recommendation. It detects preceding rules with some portions of visitors. Therefore, if there is a visitor who moved with very a different pattern compared to the whole visitors, it cannot give a correct recommendation for him/her even though we increase the number of recommendation. Trained by the whole visitors, it cannot correctly give recommendation to visitors who have a unique path. Second, the performance of general recommendation systems increase as time expands. However, our methodology shows higher performance with limited information like one or two time periods. Therefore, not only can it recommend even if there is not much information of the target visitors' booth visit records, but also it uses only small amount of information in recommendation process. We expect that it can give real?time recommendations in exhibition environment. Overall, our methodology shows higher performance ability than traditional Collaborative Filtering systems, we expect it could be applied in booth recommendation system to satisfy visitors in exhibition environment.