• Journal of Radiopharmaceuticals and Molecular Probes
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• v.6 no.2
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• pp.61-68
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• 2020

Aggregated neurofibrillary tangles (NFTs) are a pathological hallmark in Alzheimer's disease (AD) and many radiopharmaceuticals targeting NFTs have been developed so far. Among these, [¹⁸F]flortaucipir (TAUVID^TM) is the first approved radiopharmaceutical in the Food and Drug Administration (FDA) to image tau pathology. In the present study, we describe the optimized radiosynthetic method for the routine production of [¹⁸F] flortaucipir using a commercialized automation module (i.e. GE TRACERlab^TM FX_FN pro). [¹⁸F]Flortaucipir was prepared by nucleophilic substitution from its N-tert-butoxycarbonyl protected nitro precursor, tertbutyl 7-(6-nitropyridin-3-yl)-5H-pyrido[4,3-b]indole-5-carboxylate, at 130℃ for 10 min in dimethyl sulfoxide. The mean radiochemical yield was 20 ± 4.3% (decay-corrected, n = 47) with the molar activity of 218 ± 32 GBq/µmol at the end of synthesis. The radiochemical purity was determined to be above 95%. The overall production time including quality control is approximately 100min. The final produced [¹⁸F]flortaucipir injection meets the USP criteria for quality control. Thus, this fully automated system is validated for clinical use.

• The Korean Journal of Nuclear Medicine Technology
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• v.27 no.1
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• pp.62-65
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• 2023

Purpose The purpose of this study is to determine whether the glucose loading method (GLM) is useful in the differentiation of cerebral gliomas by comparing it with fasting images. Materials and Methods The patients were 70 people diagnosed with cerebral gliomas, and the equipment was Discovery 710 (GE Healthcare, MI, USA). All patients fasted for more than 6 hours, and fasting images and GLM were performed under the same imaging conditions, and the examination interval was 1 to 14 days. GLM administered 250 ㎖ of 10% glucose solution prior to radiopharmaceutical injection. SUVmax of cerebral glioma and SUVmean of cerebral cortex were measured and then compared and analyzed by tumor-to-normal brain cortex ratio (TNR). Statistical analysis confirmed the difference between the two images with an independent-sample t-test. Results The averages of GLM and fasting TNR were 1.26 and 1.09, respectively, which were 15.6% higher in GLM. In low-grade, the difference in TNR was insignificant at 4%, but in high-grade, 23%, GLM was high. There was a statistically significant difference between the two images (P=0.008), but there was no statistically significant difference in TNR in the low grade (P=0.473), and there was a very significant difference in the high grade (P=0.005). Conclusion GLM increased TNR for cerebral gliomas. In particular, it was found that the TNR increased more in the high grade. Therefore, GLM is considered to be useful for the differentiation of high-grade gliomas.

• Journal of Radiation Industry
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• v.17 no.4
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• pp.417-425
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• 2023

Lutetium(¹⁷⁷Lu), with its theranostic properties, is one of the most widely used radioisotopes and has a large share of the radiopharmaceutical market due to its many applications and targeted therapeutic research using lutetium-based radiopharmaceuticals. However, lutetium-based radiopharmaceuticals currently approved by the US Food and Drug Administration (FDA) are limited to the indications of gastrointestinal cancer, pancreatic neuroendocrine cancer and metastatic castration-resistant prostate cancer. To overcome these limitations, we aimed to demonstrate the feasibility of expanding the use of lutetium-based radiopharmaceuticals by verifying the availability and therapeutic efficacy of lutetium produced in a research reactor(HANARO). In this study, we confirmed the therapeutic efficacy of lutetium by using cancer cells from different types of cancer. In addition, we selected cancer biomarkers based on characteristics common to various cancer cells and compared and evaluated the therapeutic efficacy of lutetium by regulating the expression of target genes. The results showed that modulation of cancer biomarker gene expression resulted in higher therapeutic efficacy compared to lutetium alone. In conclusion, this study verified the potential use and therapeutic efficacy of lutetium based on the production of a research reactor (HANARO), providing fundamental evidence for the development of lutetium-based radiopharmaceuticals and the expansion of their indications.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.41-44
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• 2010

Purpose: Along with recent advances in PET/CT instrumentation and imaging technology, the number of patients has also been steadily increasing. This resulted in the increased radiation exposure to radiation workers in PET/CT rooms. In this study, we installed a radiation shield and investigated whether it could reduce radiation exposure to the workers and thus enhance job satisfaction. Materials and Methods: A radiation shield is composed of 5 cm thick lead and has a structure in which a radiation worker sits and watches a patient through lead glass while injecting radiopharmaceutical to the patient. Quarterly absorbed dose of radiation workers was measured using thermoluminescence dosimeters (TLD) and the results were compared for six months each before and after installation of the radiation shield. Exposure dose was also measured using a pocket dosimeter placed at the same location in the front and the back of the radiation shield. In addition, frequency of use of the shield and job satisfaction of radiation workers were investigated using a survey. Results: Quarterly absorbed dose of radiation workers was 2.70 mSv on average before installation of new radiation shield, whereas that dropped to 2.13 mSv after installation of radiation shield, reducing radiation exposure dose by 21%. Exposure dose on the front side of the shield was 61.2 R, whereas that on the back side of shield was 2.8 R. According to the survey, 85% of workers used the shield and were satisfied with the outcome: each radiation worker made injections to patients average of 6.5 times/day and preferred sitting to standing while injecting radiopharmaceutical to patients. Conclusion: Use of radiation shield reduced the exposure dose of radiation workers, which is the ultimate goal of radiation protection to minimize radiation exposure and is an appropriate method for the improvement of hospital working environment. Furthermore, we found that use of radiation shield not only relieves physical and psychological burden of radiation workers but also enhances job satisfaction. This result indicates that use of radiation shield is important for improvement of the radiation workers' job environment in terms of radiation protection.

• The Korean Journal of Nuclear Medicine
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• v.37 no.6
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• pp.364-373
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• 2003

Purpose: For good quality of myocardial perfusion images, an approximately 30 min to 1 hour of waiting time after radiopharmaceutical injection and ingestion of fatty meal are asked of the patients. The aim of this study was to investigate the shortening of waiting time after radiopharmaceutical injection and improvement of image quality using natural plant extracts that promote bile excretion. Materials and Methods: Ten volunteers participated in protocol 1 (7 men, 3 women; mean age, $24.1{\pm}2.4$ years) and protocol 2 (8 men, 2 women; mean age, $26.1{\pm}2.9$ years), respectively. For the modified method of both protocols, subjects took natural plant extracts 15 minutes before the first injection of $^{99m}Tc$ MIBI without laking fatty meals. Control (Conventional) methods were peformed with intake of a fatty meal 20 to 30 minutes after $^{99m}Tc$ MIBI injection. Results: As the results of protocol 1 and 2, the ratio of myocardial to lung ratio were not different between modified and conventional method. Liver to lung ratio of modified method showed significantly lower value than that of conventional method. In modified method, myocardial to liver ratio was higher persistently. In protocol 2, natural plant extracts took before the first injection of $^{99m}Tc$ MIBI exerted accelerating effect of excretion of bile juice into Intestine until the end of examination. Conclusion: These results represent that natural plant extracts for facilitation of bile excretion before injection of $^{99m}Tc$ MIBI may provide better quality of myocardial perfusion images without the need for preparations such as ingestion of fatty meal within the 2 hours compared with conventional method.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.90-93
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• 2011

Purpose: A Pixelated BSGI gamma camera has features to enhance resolution and sensitivity and minimize the distance between detector and organs by narrow FOV. Therefore, it is known as useful device to examine small organs such as thyroid, parathyroid and gall bladder. In general, when we would like to enlarge the size of images and obtain high resolution images by gamma camera in nuclear medicine study, we use pinhole collimator. The purpose of this study is to evaluate the usefulness of Pixelated BSGI gamma camera and to compare to it using pinhole collimator in thyroid scan which is a study of typical small organs. Materials and methods: (1) The evaluation of sensitivity and spatial resolution: We measured sensitivity and spatial resolution of Pixelated BSGI with LEHR collimator and Infinia gamma camera with pinhole collimator. The sensitivity was measured by point source sensitivity test recommended by IAEA. We acquired images considering dead time in BSGI gamma camera for 100 seconds and used $^{99m}TcO4-\;400{\mu}Ci$ line source. (2) The evaluation of thyroid phantom: The thyroid phantom was filled with $^{99m}TcO4-$. After set 300 sec or 100 kcts stop conditions, we acquired images from both pixelated BSGI gamma camera and Infinia gamma camera with LEHR collimator. And we performed all thyroid studies in the same way as current AMC's procedure. Results: (1) the result of sensitivity: As a result, the sensitivity and spatial resolution of pixelated BSGI gamma camera were better than Infinia's. The sensitivities of pixelated BSGI and Infinia gamma camera were $290cps/{\mu}Ci$ and $350cps/{\mu}Ci$ respectively. So, the sensitivity of pixelated BSGI was 1.2 times higher than Infinia's (2) the result of thyroid phantom: Consequently, we confirmed that images of Pixelated BSGI gamma camera were more distinguishable between hot and cold spot compared with Infinia gamma camera. Conclusion: A pixelated BSGI gamma camera is able to shorten the acquisition time. Furthermore, the patients are exposed to radiation less than before by reducing amount of radiopharmaceutical doses. Shortening scan time makes images better by minimizing patient's breath and motion. And also, the distance between organ and detector is minimized because detector of pixelated BSGI gamma camera is small and possible to rotate. When patient cannot move at all, it is useful since device is feasible to move itself. However, although a pixelated BSGI gamma camera has these advantages, the effect of dead time occurs over 2000 cts/s since it was produced only for breast scan. So, there were low concentrations in organ. Therefore, we should consider that it needs to take tests to adjust acquisition time and amount of radiopharmaceutical doses in thyroid scan case with a pixelated BSGI gamma camera.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.2
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• pp.79-83
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• 2018

Purpose $^{18}F-FDG$, which is commonly used in PET-CT examinations, is low in capacity and it is difficult to keep the amount of radioactivity busy when the specific activity is high, increasing the amount of space dose and radioactive contamination in the distribution room. Therefore, while evaluating the actual dose administered to patients during the manual dispense process, the medical institution intends to assess the usefulness of the auto dispenser by comparing the differences from the actual dose administered to the patient using the new automatic dispense. Materials and Methods From July 2016 to December 2016, 846 patients were manually administered by workers using $^{18}F-FDG$ and $^{18}F-FDG$ 906 patients were using auto dispenser from July 2017 to December 2017. Results Capacity administered to patients during the manual dispense averaged $35.41{\pm}27.79%$ compared to the recommended dose, and the auto dispenser process showed a small difference of $-2.15{\pm}3.99%$ compared to the recommended dose(p<0.05). Conclusion Working people did not have to touch radioactive medicines directly while they were busy in the auto dispenser, and because of the availability of other tasks far away, the time and distance to receive the exposure were also advantageous. It is believed that future use by many medical institutions will not only reduce the dose to patients but also help reduce the exposure dose to workers.

• Journal of Biomedical Engineering Research
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• v.37 no.1
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• pp.7-14
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• 2016

Radiopharmaceutical agents for positron emission tomography (PET), such as $^{18}F$-FDG and $^{68}Ga$, have been used not only for whole-body PET imaging but also for intraoperative radionuclide-guided surgery due to their quantitative and sensitive imaging characteristics. Current intraoperative probes detect gamma or beta particles, but not both of them. Gamma probes have low sensitivities since a collimator has to be used to reduce backgrounds. Positron probes have a high tumor-to-background ratio, but they have a 1-2 mm depth limitation from the body surface. Most of current intraoperative probes produce only audible sounds proportional to count rates without providing tumor images. This research aims to detect both positrons and annihilation photons from $^{18}F$ using plastic scintillators and a GAGG scintillation crystal attached to silicon photomultiplier (SiPM). The depth-of-interaction (DOI) along the plastic scintillator can be used to obtain the 2-D images of tumors near the body surface. The front and rear part of the intraoperative probe consists of $4{\times}1$ plastic scintillators ($2.9{\times}2.0{\times}12.0mm^3$) for positron detection and a Ce:GAGG scintillation crystal ($12.0{\times}12.0{\times}9.0mm^3$) for annihilation photon detection, respectively. The DOI resolution of $4.4{\pm}1.6mm$ along the plastic scintillator was obtained by using the 3M enhanced specular reflector (ESR) with rectangular holes between the plastic scintillators, which showed the feasibility of a 2-D image pixel size of $2.9{\times}4.4mm^2$ (X-direction ${\times}$ Y-direction).

• Journal of Radiation Protection and Research
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• v.37 no.4
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• pp.231-236
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• 2012

This study derived measures to reduce exposure doses by identifying factors which affect the external radiation dose rate of patients treated with radiopharmaceuticals for PET-CT tests. The external radiation dose rates were measured on three parts of head, thorax and abdomen at a distance of 50cm from the surface of 60 PET-CT patients. It showed there are changes in factors affecting the external radiation dose rate over time after the administration of F-18 FDG. The external radiation dose rate was lower in the patients with more water intake than those with less water intake before the injection of radiopharmaceuticals at all three points: right after the injection of radiopharmaceuticals (average 4.17 mins), after the pre-PEET-CT urination step (average 77.47 mins), and right after the PET-CT test (average 114.15 mins). The study also found there is a need to increase the amount of water intake before the injection of radiopharmaceuticals in order to maintain a low external radiation dose rate in patients. This strategy is only possible under the assumption that the quality of the video has not changed after conducting this study on the relations between the image and quality. This study also found a need to use radiopharmaceuticals with the minimum amount needed for each patient because F-FDG doses affects the external radiation dose rate at the point right after the injection of radiopharmaceuticals. Urination frequency was the most significant factor to affect the external radiation dose rates at the point right after the PET-CT test and the point after the pre-PET-CT urination step. There is a need to realize the strategy to increase the urination frequency of patients to maintain the external radiation dose rate low (average 77.47 mins) before and after the injection of radiopharmaceuticals. In addition, at this point, there is a need to take advantage of personal strategies because the external radiation dose rate is lower if the fasting time is shorter, the contrast medium is used, and the amount of water intake is increased after the administration of radiopharmaceuticals. Finally this study found the need to be able to generalize these findings through an in-depth research on the factors affecting the external radiation dose rate, which includes radiopharmaceutical dose, urination frequency, the amount of water intake, fasting time and the use of contrast medium.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.6
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• pp.451-455
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• 2008

Purpose: Lymphoscintigraphy and sentinel node biopsy has become a standard method for detection of axillary lymph node metastasis in breast cancer patients, but the standard radiopharmaceutical was not prepared. About detection of axillary lymph node metastasis by lymphoscintigraphy and sentinel node biopsy in breast cancer patient, we compared the results of Tc-99m Tin-colloid and Tc-99m Phytate by subareolar injection. Materials and Methods: This study included 382 breast cancer patients who were performed operation during 2001-2008. Three hundred forty nine patients was injected 0.8ml of Tc-99m Tin-colloid (37-185 MBq) by subareolar injection. Thirty three patients was injected 0.8ml of Tc-99m Phytate (37-185 MBq). Lymphoscintigraphy was performed in supine position and sentinel node localization was performed by hand-held gamma probe in operation. Result: Among 349 patients by Tc-99m Tin-colloid, 312 cases (89.4%) localized the sentinel node by lymphoscintigraphy, 304 cases (87.1%) localized by gamma probe. Among 33 patients by Tc-99m Phytate, 32 cases (97.0%) localized by lymphoscintigraphy, 33 cases (100%) localized by gamma probe. Detection rate by lymphoscintigraphy and gamma probe was superior for Tc-99m Phytate compared to that with Tc-99m Tin-colloid, with a statistically significant difference. (p<0.05, p<0.05) Conclusion: Tc-99m Phytate is a better choice for localization of sentinel node than Tc-99m Tin-colloid in breast cancer patients.