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The Comparison of Quantitative Accuracy Between Energy Window-Based and CT-Based Scatter Correction Method in SPECT/CT Images (SPECT/CT 영상에서 에너지창 기반 산란보정과 CT 기반 산란보정 방법의 정량적 정확성 비교)

  • Kim, Ji-Hyeon;Son, Hyeon-Soo;Lee, Juyoung;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.19 no.2
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    • pp.93-101
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    • 2015
  • Purpose In SPECT image, scatter count is the cause of quantitative count error and image quality degradation. Thus, a wide range of scatter correction(SC) methods have been studied and this study is to evaluate the accuracy of CT based SC(CTSC) used in SPECT/CT as the comparison with existing energy window based SC(EWSC). Materials and Methods SPECT/CT images were obtained after filling air in order to acquire a reference image without the influence of scatter count inside the Triple line insert phantom setting hot rod(74.0 MBq) in the middle and each SPECT/CT image was obtained each separately after filling water instead of air in order to derive the influence of scatter count under the same conditions. In both conditions, Astonish(iterative : 4 subset : 16) reconstruction method and CT attenuation correction were commonly applied and three types of SC methods such as non-scatter correction(NSC), EWSC, CTSC were used in images filled with image. For EWSC, 9 sub-energy windows were set additionally in addition to main(=peak) energy window(140 keV, 20%) and then, images were acquired at the same time and five types of EWSC including DPW(dual photo-peak window)10%, DEW(dual energy window)20%, TEW(triple energy window)10%, TEW5.0%, TEW2.5% were used. Under the condition without fluctuations in primary count, total count was measured by drawing volume of interest (VOI) in the images of the two conditions and then, the ratio of scatter count of total counts was calculated as percent scatter fraction(%SF) and the count error with image filled with water was evaluated with percent normalized mean-square error(%NMSE) based on the image filled with air. Results Based on the image filled with air, %SF of images filled with water to which each SC method was applied is NSC 37.44, DPW 27.41, DEW 21.84, TEW10% 19.60, TEW5% 17.02, TEW2.5% 14.68, CTSC 5.57 and the most scattering counts were removed in CTSC and %NMSE is NSC 35.80, DPW 14.28, DEW 7.81, TEW10% 5.94, TEW5% 4.21, TEW2.5% 2.96, CTSC 0.35 and the error in CTSC was found to be the lowest. Conclusion In SPECT/CT images, the application of each scatter correction method used in the experiment could improve the quantitative count error caused by the influence of scatter count. In particular, CTSC showed the lowest %NMSE(=0.35) compared to existing EWSC methods, enabling relatively accurate scatter correction.

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The study of Breast Specific Gamma Imaging Protocol using Self-development Phantom (자체 제작된 팬텀을 적용한 Breast Specific Gamma Imaging 검사 프로토콜에 대한 고찰)

  • Lee, Hae-Jung;Lee, Juyoung;Lim, Kuen-Kyo;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.39-47
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    • 2014
  • Purpose As breast cancer patients continue to increase every year, cases of BSGI are on the rise with a heavier reliance on it. However, BSGI protocol in hospitals was not studied enough despite it was covered by hospital's condition and recommendation of manufacturers. The objective of the study was an examination of methods to be applicable to BSGI protocols, putting the self-development phantom to use in quality assessment of the images. Materials and Methods Dilon 6800 (Dilon Technologies Inc, Newport News, USA) was used in the study and five different sizes of sphere were distinctively produced in the phantom. The study used $^{99m}TcO_4$. The cases were classified in to three categories that background radioactivity to region of interest as ratio of 2: 4: 8, They were acquired images for 5, 7, 10mins. The acquired image was set region of interest according to the size of sphere, and We analyzed quantitative and qualitative analysis. The acquired data statistically analyzed with SPSS ver.18.0. Results As the result of quantitative and qualitative analysis, count rate of each sphere in accordance with difference of injection dose showed that higher count rate as injection dose and sphere size increased (P<0.005). Count rate of each sphere in accordance with difference of acquisition time showed that higher count rate as acquisition time and sphere size increased (P<0.005). Contrast noise ratio of each sphere in accordance with difference of injection dose showed that higher contrast noise ratio as injection dose increased. Particularly, Contrast noise ratio of eight times ratio images was the highest among. Contrast noise ratio of each sphere in accordance with difference of acquisition time showed that higher contrast noise ratio as acquisition time increased. And, Contrast noise ratio of seven minute image was the highest among (P<0.005). Conclusion There was significant change of Contrast noise ratio through quantitative and qualitative analysis. Moreover, We found usefulness of phantom. If Institutions identified image through the phantom study and they made BSGI protocol, We expected to help the improvement of diagnostic value of the images.

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The Usability Evaluation of the Usefulness of Bismuth Shields in PET/CT Examination (PET/CT 검사에서 비스무스(bismuth) 차폐체의 적용에 따른 유용성 평가)

  • Park, Hoon-Hee;Lee, Juyoung;Kim, Ji-Hyeon;Nam, Kun-Sik;Lyu, Kwang-Yeul;Lee, Tae Soo
    • Journal of radiological science and technology
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    • v.37 no.1
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    • pp.49-56
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    • 2014
  • Recently with CT developed, various studies for reduction of exposure dose is underway. Study of bismuth shields in these studies is actively underway, and has already been applied in the clinical. However, the application of the PET/CT examination was not activated. Therefore, through this study, depending on the application of bismuth shields in the PET/CT examination, we identify the quality of the image and the impact on the Standard Uptake Value (SUV). In this study, to apply to the shielding of the breast, by using the bismuth shields that contains 0.06 mm Pb ingredients, was applied to the PET/CT GEMINI TF 64 (Philips Healthcare, Cleveland, USA). Phantom experiments using the NEMA IEC Body Phantom, images were acquired according to the presence or absence of bismuth shields apply. Also, When applying, images were obtained by varying the spacing 0, 1, 2 cm each image set to the interest range in the depth of the phantom by using EBW-NM ver.1.0. When image of the PET Emission acquires, the SUV was in increased depending on the use of bismuth shields, difference in the depth to the surface from deep in the phantom increasingly SUV increased (P<0.005). Also, when using shields, as the more gab decreased, SUV is more increased (P<0.005). Through this study, PET/CT examination by using of bismuth shields which is used as purpose of reduction dose. When using shields, the difference of SUV resulting from the application of bismuth shields exist and that difference when gab is decrease and surface is wider. Therefore, setting spacing of shield should be considered, if considering the reduction of the variation of SUV and image quality, disease of deep organs should be a priority rather than superficial organ disease. Use of bismuth shielding factor considering the standard clinical examination, decrease unnecessary exposure can be expected to be considered.

$H_2$ Receptor Antagonists and Gastric Cancer in the Elderly: A Nested Case-Control Study (노인 인구에서 $H_2$ Receptor Antagonist와 위암과의 관련성: 코호트 내 환자-대조군 연구)

  • Kim, Yoon-I;Heo, Dae-Seog;Lee, Seung-Mi;Youn, Kyoung-Eun;Koo, Hye-Won;Bae, Jong-Myon;Park, Byoung-Joo
    • Journal of Preventive Medicine and Public Health
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    • v.35 no.3
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    • pp.245-254
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    • 2002
  • Objective : To test if the intake of $H_2$ receptor antagonists ($H_2$-RAs) increases the risk of gastric cancer in the elderly. Methods : The source population for this study was drawn from the responders to a questionnaire survey administered to the Korea Elderly Pharmacoepidemiological Cohort (KEPEC), who were beneficiaries of the Korean Medical Insurance Corporation, were at least 65 years old, and residing in Busan in 1999. The information on $H_2$-RAs exposure was obtained from a drug prescription database compiled between inn. 1993 and Dec. 1994. The cases consisted of 76 gastric cancer patients, as confirmed from the KMIC claims data, the National Cancer Registry and the Busan Cancer Registry. The follow-up period was from Jan. 1993 to Dec. 1998. Cancer free controls were randomly selected by 1:4 individual matching, which took in to consideration the year of birth and gender. Information on confounders was collected by a mail questionnaire survey. The odds ratios, and their 95% confidence intervals, were calculated using a conditional logistic regression model. Results : After adjusting for a history of gastric ulcer symptoms, medication history, and body mass index, the adjusted OR (aOR) was 4.6 (95% CI=1.72-12.49). The odds ratio of long term use (more than 7 days) was 2.3 (95% CI=1.07-4.82). The odds ratio of short term use was 4.6 (95% CI=1.26-16.50). The odds ratio of parenteral use was 4.4 195% CI=1.16-17.05) and combination use between the oral and parenteral routes (aOR, 16.8; 95% CI=1.21-233.24) had the high risk of gastric cancer. The aOR of cimetidine was 1.7 (95% CI=1.04-2.95). The aOR of ranitidine was 2.0 (95% CI=1.21-3.40). The aOR of famotidine was 1.7 (95% CI=0.98-2.80). Conclusion : The intake of $H_2$-RAs might increase the risk of gastric cancer through achlorhydria in the elderly.

Consideration of Standardized Uptake Value (SUV) According to the Change of Volume Size through the Application of Astonish TF Reconstruction Method (Astonish TF 재구성 기법의 적용을 통한 체적 크기의 변화에 따른 표준섭취계수(SUV)에 관한 고찰)

  • Lee, Juyoung;Nam-Kung, Sik;Kim, Ji-Hyeon;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.115-121
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    • 2014
  • Purpose: In addition to improving the quality of the PET image, through much research, the development of various programs are performed. Astonish TF reconstruction techniques by Philips can confirm the improved contrast of the lesion. Also, It's image reconstruction of 2 mm is possible with rapid reconstruction rate than conventional. In this study, we compared and evaluated Standardized Uptake Value (SUV) in accordance with the 2 mm reconstruction techniques and traditional 4 mm from the $^{18}F-FDG$ PET whole body image. Materials and Methods: In the phantom experiment, NEMA IEC body phantom (sphere: 10, 13, 17, 22, 28, 37 mm) was used to obtain images by using GEMINI TF 64 PET/CT (Philips, Cleveland, USA). Also, In the clinical images, we performed $^{18}F-FDG$ PET/CT examination to 30 women (age: $55.1{\pm}11.3$, BMI: $24.1{\pm}2.9$) with a diagnosis of breast cancer. After that, we reconstructed images in 2 mm and 4 mm respectively. The region of interest was drawn to acquired images. Since then, we measured SUV and statistically analyzed with SPSS ver.18 by using EBW (Extended Brilliance Workstation) NM ver.1.0. Results: After analyzing the result of the phantom study, there was a tendency that the bigger hot sphere size, the higher SUV. If you compared the 2 mm reconstruction techniques to 4 mm, it increased 95.78% in 10 mm, 50.60% in 13 mm, 25.00% in 17 mm, 30.04% in 22 mm, 31.81% in 28 mm, and 27.84% in 37 mm. Through the result of the analysis of the 2 mm reconstruction techniques and 4 mm in clinical images, it appeared that SUV of 2 mm was higher than that of 4 mm. Also the smaller the volume was, the more the change rate increased. Conclusion: After analyzing the result of the clinical picture and phantom experiments applied by Astonish TF reconstruction techniques, as the size of the volume was small, the change rate of the SUV increased. Therefore, it was necessary to further research about the SUV correction for accurate and active utilization of 2 mm reconstruction techniques which had excellent lesion discrimination ability and contrast in clinic.

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Dry Matter Yield of Japanese Millet (Echinochloa crusgalli var. Frumentacea 〈Roxb.〉 Wight), Chemical Properties and Microbial Population of Soil as Affected by the Application of Fermented Sawdust Swine Manure in Cheju Volcanic Ash Soil Area (제주화산회토양에서 발효 톱밥 돈분 시용이 피의 건물수량, 토양의 이화학적 성질 및 토양 미생물에 미치는 영향)

  • Kim M. C.;Kim T. G.;Lee J. E.;Moon B. C.
    • Journal of The Korean Society of Grassland and Forage Science
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    • v.25 no.3
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    • pp.159-168
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    • 2005
  • This experiment was carried out during the period from May to October 1998 to determine the effect of fermented sawdust swine manure application (SSM) on the herbage production of Japanese millet and soil properties in the Cheju brown volcanic ash soil. The randomized block design (T1 : basic chemical fertilizer, N 200 kg/ha + $P_2O_5\;300 kg/ha+K_2O$ 200kg/ha ; T2 : 1/2 basic chemical fertilizer, N $100+P_2O_5\;150+K_2O$ 100kg/ha; T3 : 1/2 basic SSM, N 100kg/ha, T4:basic SSM, N 200kg/ha; T5:2 times basic SSM, N 400 kg/ha ; T6:4 times basic SSM, N 800 kg/ha) was used. At the same application level of nitrogen 200kg/ha, the application of $100\%$ chemical fertilizer (T1) had significantly lower dry matter yield than that of $50\%$ chemical fertilizer and $50\%$ SSM (T2) or $100\%$ SSM (T4)(p<0.01). Dry matter yield increased with an increase of SSM application to N 400kg/ha level but decreased at N 800 kg/ha level. P, K and Ca contents of Japanese millet tended towards to decrease with an increase of SSM level. The application of chemical fertilizer lowered P and K content of Japanese millet in comparison with that of SSM (p<0.05). pH, available phosphorus. exchangeable potassium, Ca and Mg content of soil studied showed a significant increase with an increase of SSM application level (p<0.05). However, at the same application level of N 200kg/ha, there was statistically no significant difference between chemical fertilizer and SSM in those contents of soil after experiment. The bacterial number of soil among microbial population increased with an increase of SSM level, in June, 1998 (p<0.05), but there was no regular tendency, in October. The rate of bacteria to fungus in soil had a tendency to decrease with an increase of SSM level. In conclusion, it is recommended to use N 400kg/ha of SSM or N 100 kg/ha of chemical fertilizer+N 100 kg/ha of SSM for Japanese millet.

Applicability of American and European Spirometry Repeatability Criteria to Korean Adults (한국 성인을 대상으로 한 미국 및 유럽 폐활량 검사 재현성 기준의 유용성)

  • Park, Byung Hoon;Park, Moo Suk;Jung, Woo Young;Byun, Min Kwang;Park, Seon Cheol;Shin, Sang Yun;Jeon, Han Ho;Jung, Kyung Soo;Moon, Ji Ae;Kim, Se Kyu;Chang, Joon;Kim, Sung Kyu;Ahn, Song Vogue;Oh, Yeon-Mok;Lee, Sang Do;Kim, Young Sam
    • Tuberculosis and Respiratory Diseases
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    • v.63 no.5
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    • pp.405-411
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    • 2007
  • Background: The objective of this study was to evaluate the clinical applicability of the repeatability criteria recommended by the American Thoracic Society/European Respiratory Society (ATS/ERS) spirometry guidelines and to determine which factors affect the repeatability of spirometry in Korean adults. Methods: We reviewed the spirometry data of 4,663 Korean adults from the Korean National Health and Nutritional Examination Survey (KNHANES) Chronic Obstructive Pulmonary Disease Cohort (COPD cohort) and the Community-based Cohort Study VI-Fishing village/Islands (community cohort). We measured the anthropometric factors and differences between the highest and second-highest FVC (dFVC) and $FEV_1$ ($dFEV_1$) from prebronchodilator spirometry. Analyses included the distribution of dFVC and $dFEV_1$, comparison of the values meeting the 1994 ATS repeatability criteria with the values meeting the 2005 ATS/ERS repeatability criteria, and the performance of linear regression for evaluating the influence of subject characteristics and the change of criteria on the spiro-metric variability. Results: About 95% of subjects were able to reproduce FVC and $FEV_1$ within 150 ml. The KNHANES based on the 1994 ATS guidelines showed poorer repeatability than the COPD cohort and community cohort based on the 2005 ATS/ERS guidelines. Demographic and anthropometric factors had little effect on repeatability, explaining only 0.5 to 3%. Conclusion: We conclude that the new spirometry repeatability criteria recommended by the 2005 ATS/ERS guidelines is also applicable to Korean adults. The repeatability of spirometry depends little on individual characteristics when an experienced technician performs testing. Therefore, we suggest that sustained efforts for public awareness of new repeatability criteria, quality control of spirograms, and education of personnel are needed for reliable spirometric results.

Treatment Outcomes and Prognostic Factors in Patients with Multidrug-Resistant Tuberculosis in Korean Private Hospitals (국내 민간병원에서 치료한 다제내성결핵 환자의 치료 결과 및 예후 인자)

  • Park, Jin-Kyeong;Koh, Won-Jung;Kim, Deog-Kyeom;Kim, Eun-Kyung;Kim, Yu-Il;Kim, Hee-Jin;Kim, Tae-Hyung;Kim, Jae-Yeol;Park, Moo-Suk;Park, I-Nae;Park, Jae-Seuk;Lee, Ki-Man;Song, Sook-Hee;Lee, Jin-Hwa;Lee, Seung-Heon;Lee, Hyuk-Pyo;Yim, Jae-Joon;Lim, Jae-Min;JeGal, Yang-Jin;Jung, Ki-Hwan;Huh, Jin-Won;Choi, Jae-Chol;Shim, Tae-Sun
    • Tuberculosis and Respiratory Diseases
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    • v.69 no.2
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    • pp.95-102
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    • 2010
  • Background: The increasing rate of drug-resistant tuberculosis (TB) is a threat to the public health and TB control. In Korea, about 75~80% of TB patients are treated in private hospitals and the rate has been continuously increasing since 2000. Methods: On a retrospective basis, we enrolled 170 newly diagnosed with or retreated for multidrug-resistant TB (MDR-TB) in 2004 from 21 private hospitals. We extracted the following demographics and treatment history from patient medical records: initial treatment outcomes, cumulative survival rates, treatment outcomes, and prognostic factors. Results: Of the 170 patients, the majority were male (64.1%), the mean age was 44.5 years old, and mean body-mass-index was $20.2kg/m^2$. None of the patients tested positive for HIV. Eleven (6.5%) were confirmed to have extensively drug-resistant TB (XDR-TB) at treatment initiation. Treatment success rates were not different between XDR-TB (36.4%, 4/11) and non-XDR MDR-TB (51.6%, 82/159). Default rate was high, 21.8% (37/170). Far advanced disease on X-ray was a significant negative predictor of treatment success; advanced disease and low BMI were risk factors for all-cause mortality. Conclusion: In private hospitals in Korea, the proportion of XDR-TB in MDR-TB was comparable to previous data. The treatment success rate of MDR-/XDR-TB remains poor and the failure rate was quite high. Adequate TB control policies should be strengthened to prevent the further development and spread of MDR-/XDR-TB in Korea.

The Factors for Food Service Satisfaction of the Elderly Welfare Center Free Lunch Program Participants in Busan (부산 일부지역 복지관 무료급식 이용노인들의 급식만족도에 영향을 미치는 요인)

  • Lee, Jeong-Sook
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.40 no.1
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    • pp.128-136
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    • 2011
  • This study was carried out to investigate the factors of food service satisfaction of the elderly in Busan. The survey was conducted from September 1 to October 15, 2009 by questionnaires and data analyzed by SPSS program. Fifty point nine percent of the subjects lived alone and the source of living expenses of 70.5% of the subjects was subsidy from government. The most important reason for the elderly to participate in meal service was 'economic difficulty' and 'to meet friend'. The subjects had various chronic degenerative diseases, such as arthritis, hypertension, diabetes, osteoporosis and cardiac disease. Sixty-six point eight percent of the subjects needed diet therapy for their diseases, but 87.1% of them don't want to pay the extra fee. Thirty six point five percent of the subjects attained information about lunch program because it was 'close to home' but 20.7% was 'from public officials'. The reasons for the use of the meal service were 'economic difficulty' (40.0%), 'to meet friends' (22.6%), and 'bother to prepare meal' (16.50%). The services provided by welfare center were health care, physical exam and haircut. The score given by the subjects on the satisfaction of meal service was 3.84 on the 5-point maximum scale. Higher satisfaction on kindness of staff, satisfaction of social support and awareness of support resulted in higher satisfaction of food service. It would be effective to provide food service models that meet specific needs of the elderly according to social welfare service and social community activities.

A Study on the Dietary Behaviors, Physical Development and Nutrient Intakes in Preschool Children (학령 전 아동의 식습관, 신체 발달 및 영양 섭취상태에 관한 연구)

  • Yu, Kyeong-Hee
    • Journal of Nutrition and Health
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    • v.42 no.1
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    • pp.23-37
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    • 2009
  • The purpose of this study was to investigate the health status of preschool children using the questionnaires about dietary behaviors and anthropometric indices. And also nutritional status was investigated using questionnaires for 24-hr recall method. The study was conducted in 145 children aged 3 to 6 years and questionnaires for dietary behaviors and dietary intakes were performed by mothers of children in Ulsan. Just nine percent of children were graded as good in terms of having healthy eating habits, this means that the nutrition education for the dietary behaviors should be more focused on preschool children. With regard to the frequency of food intake, children consumed green & yellow vegetables less frequently, meanwhile consumed high protein source food (meat, egg and bean) and milk and its product more frequently. Children almost never consumed fried foods as often as 1-2 times a weak. In assessment of the health status, children have the highest prevalence of colds and allergy, but lower prevalence of clinical symptoms due to the nutritional deficiency. The mean height was $103.6\;{\pm}\;6.4\;cm$ and significantly different among age (p < 0.05), but was not significantly different between sex. The mean weight was $17.8\;{\pm}\;3.0\;kg$ and significantly different in 5, 6years old among age. By the WLI criteria, 11.1% of children were underweight and 17.4% of children were overweight or obese. By the Rohrer index criteria, any children were not underweight and 86.8% of children were overweight or obese. By the Kaup index criteria, 2.8% of children were underweight and 29.2% of children were overweight or obese. And Obesity Index criteria, 2.1% of children were underweight and 20.8% of children were overweight or obese. The results of obesity rate by all criteria except Rohrer index indicated similar level, were significantly high in age 3 with all criteria, and decreased with age increased. The energy intake of children was lower than EER (Estimated Energy Requirements) of Dietary Reference Intakes for Koreans (KDRIs) by as much as 85.7%. Acceptable Macronutrient Distribution Ranges (AMDR) was 62.6:21.5:15.7 as carbohydrate:protein:lipid, so children consumed protein more, but consumed lipid less compared with those of KDRIs. Vitamin A intake was 133% of recommended intakes (RI) and calcium intake which was identified as the nutrient most likely to be lacking in diets was 98.9% of RI. The intakes of all minerals and vitamins except folate were higher than KDRIs. 33.3% of children were distributed in insufficiency of energy intake, 42.7% of children were distributed in insufficiency of lipid intake. These results indicate that the need of developing of nutrition education program and further concern of a public health center, university and children care center about dietary life for preschool children.