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Evaluation of Radioactivity Concentration According to Radioactivity Uptake on Image Acquisition of PET/CT 2D and 3D (PET/CT 2D와 3D 영상 획득에서 방사능 집적에 따른 방사능 농도의 평가)

  • Park, Sun-Myung;Hong, Gun-Chul;Lee, Hyuk;Kim, Ki;Choi, Choon-Ki;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.111-114
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    • 2010
  • Purpose: There has been recent interest in the radioactivity uptake and image acquisition of radioactivity concentration. The degree of uptake is strongly affected by many factors containing $^{18}F$-FDG injection volume, tumor size and the density of blood glucose. Therefore, we investigated how radioactivity uptake in target influences 2D or 3D image analysis and elucidate radioactivity concentration that mediate this effect. This study will show the relationship between the radioactivity uptake and 2D,3D image acquisition on radioactivity concentration. Materials and Methods: We got image with 2D and 3D using 1994 NEMA PET phantom and GE Discovery(GE, U.S.A) STe 16 PET/CT setting the ratio of background and hot sphere's radioactivity concentration as being a standard of 1:2, 1:4, 1:8, 1:10, 1:20, and 1:30 respectively. And we set 10 minutes for CT attenuation correction and acquisition time. For the reconstruction method, we applied iteration method with twice of the iterative and twenty times subset to both 2D and 3D respectively. For analyzing the images, We set the same ROI at the center of hot sphere and the background radioactivity. We measured the radioactivity count of each part of hot sphere and background, and it was comparative analyzed. Results: The ratio of hot sphere's radioactivity density and the background radioactivity with setting ROI was 1:1.93, 1:3.86, 1:7.79, 1:8.04, 1:18.72, and 1:26.90 in 2D, and 1:1.95, 1:3.71, 1:7.10, 1:7.49, 1:15.10, and 1:23.24 in 3D. The differences of percentage were 3.50%, 3.47%, 8.12%, 8.02%, 10.58%, and 11.06% in 2D, the minimum differentiation was 3.47%, and the maximum one was 11.06%. In 3D, the difference of percentage was 3.66%, 4.80%, 8.38%, 23.92%, 23.86%, and 22.69%. Conclusion: The difference of accumulated concentrations is significantly increased following enhancement of radioactivity concentration. The change of radioactivity density in 2D image is affected by less than 3D. For those reasons, when patient is examined as follow up scan with changing the acquisition mode, scan should be conducted considering those things may affect to the quantitative analysis result and take into account these differences at reading.

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Fusion of Gamma and Realistic Imaging (감마영상과 실사영상의 Fusion)

  • Kim, Yun-Cheol;Yu, Yeon-Uk;Seo, Young-Deok;Moon, Jong-Woon;Kim, Yeong-Seok;Won, Woo-Jae;Kim, Seok-Ki
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.78-82
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    • 2010
  • Purpose: Recently, South Korea has seen a rapidly increased incidence of both breast and thyroid cancers. As a result, the I-131 scan and lymphoscintigraphy have been performed more frequently. Although this type of diagnostic imaging is prominent in that visualizes pathological conditions, which is similar to previous nuclear diagnostic imaging techniques, there is not much anatomical information obtained. Accordingly, it has been used in different ways to help find anatomical locations by transmission scan, however the results were unsatisfactory. Therefore, this study aims to realize an imaging technique which shows more anatomical information through the fusion of gamma and realistic imaging. Materials and Methods: We analyzed the data from patients who were examined by the lymphoscintigraphy and I-131 additional scan by Symbia Gamma camera (SIEMENS) in the nuclear medicine department of the National Cancer Center from April to July of 2009. First, we scanned the same location in patients by using a miniature camera (R-2000) in hyVISION. Afterwards, we scanned by gamma camera. The data we obtained was evaluated based on the scanning that measures an agreement of gamma and realistic imaging by the Gamma Ray Tool fusion program. Results: The amount of radiation technicians and patients were exposed was generated during the production process of flood source and applied transmission scan. During this time, the radiation exposure dose of technicians was an average of 14.1743 ${\mu}Sv$, while the radiation exposure dose of patients averaged 0.9037 ${\mu}Sv$. We also confirmed this to matching gamma and realistic markers in fusion imaging. Conclusion: Therefore, we found that we could provide imaging with more anatomical information to clinical doctors by fusion of system of gamma and realistic imaging. This has allowed us to perform an easier method in which to reduce the work process. In addition, we found that the radiation exposure can be reduced from the flood source. Eventually, we hope that this will be applicable in other nuclear medicine studies. Therefore, in order to respect the privacy of patients, this procedure will be performed only after the patient has agreed to the procedure after being given a detailed explanation about the process itself and its advantages.

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The Evaluation of Quantitative Accuracy According to Detection Distance in SPECT/CT Applied to Collimator Detector Response(CDR) Recovery (Collimator Detector Response(CDR) 회복이 적용된 SPECT/CT에서 검출거리에 따른 정량적 정확성 평가)

  • Kim, Ji-Hyeon;Son, Hyeon-Soo;Lee, Juyoung;Park, Hoon-Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.2
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    • pp.55-64
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    • 2017
  • Purpose Recently, with the spread of SPECT/CT, various image correction methods can be applied quickly and accurately, which enabled us to expect quantitative accuracy as well as image quality improvement. Among them, the Collimator Detector Response(CDR) recovery is a correction method aiming at resolution recovery by compensating the blurring effect generated from the distance between the detector and the object. The purpose of this study is to find out quantitative change depending on the change in detection distance in SPECT/CT images with CDR recovery applied. Materials and Methods In order to find out the error of acquisition count depending on the change of detection distance, we set the detection distance according to the obit type as X, Y axis radius 30cm for circular, X, Y axis radius 21cm, 10cm for non-circular and non-circular auto(=auto body contouring, ABC_spacing limit 1cm) and applied reconstruction methods by dividing them into Astonish(3D-OSEM with CDR recovery) and OSEM(w/o CDR recovery) to find out the difference in activity recovery depending on the use of CDR recovery. At this time, attenuation correction, scatter correction, and decay correction were applied to all images. For the quantitative evaluation, calibration scan(cylindrical phantom, $^{99m}TcO_4$ 123.3 MBq, water 9293 ml) was obtained for the purpose of calculating the calibration factor(CF). For the phantom scan, a 50 cc syringe was filled with 31 ml of water and a phantom image was obtained by setting $^{99m}TcO_4$ 123.3 MBq. We set the VOI(volume of interest) in the entire volume of the syringe in the phantom image to measure total counts for each condition and obtained the error of the measured value against true value set by setting CF to check the quantitative accuracy according to the correction. Results The calculated CF was 154.28 (Bq/ml/cps/ml) and the measured values against true values in each conditional image were analyzed to be circular 87.5%, non-circular 90.1%, ABC 91.3% and circular 93.6%, non-circular 93.6%, ABC 93.9% in OSEM and Astonish, respectively. The closer the detection distance, the higher the accuracy of OSEM, and Astonish showed almost similar values regardless of distance. The error was the largest in the OSEM circular(-13.5%) and the smallest in the Astonish ABC(-6.1%). Conclusion SPECT/CT images showed that when the distance compensation is made through the application of CDR recovery, the detection distance shows almost the same quantitative accuracy as the proximity detection even under the distant condition, and accurate correction is possible without being affected by the change in detection distance.

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The Usefulness of Q.Clear Technique in PET / CT (PET/CT 검사에서 Q.Clear 기법의 유용성에 대한 고찰)

  • Choi, Yong Hoon;Kim, Jung Yul;Choi, Young Sook;Lim, Han Sang;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.2
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    • pp.31-36
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    • 2017
  • Purpose Recently, the performance of PET/CT scanner has been improved and various techniques have been developed to increase the image quality such as Sensitivity and Resolution. The purpose of this study is to evaluate the usefulness of Q.Clear (a fully convergent iterative reconstruction) technique of GE Discovery IQ equipment to enhance the image quality. Materials and Methods All scans were acquired by Discovery IQ (GE Healthcare, MI, USA). In NEMA IEC Body Phantom test, Background to Hot-sphere (10 mm, 13 mm, 17 mm, 22 mm) ratio was 1:4 and scan time was 3 minutes. The images were reconstructed by VPHDs (VUE Point High-Definition + SharpIR) and Q.Clear to evaluate each Contrast. We injected 18F-FDG 187 M㏃ to PET/SPECT Performance Phantom. And then it was scanned for 4 minutes to evaluate Resolution and Uniformity. T-test statistical analysis was performed on SUVmax of small lesions less than 2 cm in 100 clinical patients regardless of disease type. Results In the NEMA IEC Body Phantom, the Contrast was $63.6{\pm}5.7%$ (VPHDs) and $75{\pm}4.8%$ (Q.Clear). In the PET/SPECT Performance Phantom, the Resolution was 9.2 mm (VPHDs) and 7.3 mm (Q.Clear). Uniformity of Q.Clear was 10.8% better than VPHDs. T-test statistic of the clinical patients showed a significant difference of p value of 0.021. Conclusion Both the phantom test and the clinical results showed that the quality of the image was improved in Q.Clear was applied. The SUVmax was highly measured in Q.Clear and the lesions were clearly distinguished visually. Therefore Q.Clear can be useful in various aspects such as dose-reduction, patients evaluation and image analysis.

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Growth and Production of Mactra veneriformis (Bivalvia) on the Songdo Tidal Flat, West Coast of Korea (서해 송도 갯벌에서의 동죽(Mactra veneriformis: Bivalvia)의 성장과 생산)

  • 신현출;고철환
    • 한국해양학회지
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    • v.30 no.5
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    • pp.403-412
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    • 1995
  • The present study was performed to determine th growth and production of Mactra veneriformis on the Songdo tidal flat off Inchon. west coast of Korea. Monthly samples were collected from Marc 1989 to September 1990. The size distributions of shell length showed unimodal patterns from March to August 1989. The binodal pattern after September 1989 indicated a recruitment of young clams during this period. The density fluctuated irregularly, but showed a decreasing pattern over time on the whole. The density of the year class 1989 increased markedly after February 1990. The growth in shell length showed three phases during a year, a fast growth phase in spring, a slow growth phase in summer and autumn, and a lag phase in winter. The annual increment in shell length reduced with age. The flesh dry weight showed a peak in late spring just before the spawning period, and another peak in autumn. The length of annuli and the back-calculated flesh dry weight were used to describe the annual growth. The growth in shell length fitted to the von Bertalanffy model and the flesh dry weight to the Gompertz model. The absolute growth rate of the shell length reduced gradually with age. The year class 1985 had the highest L, and the yeat class 1986 the lowest L. The annual growth in weight showed a typical sigmoid curve. The growth rate was maximum at the age of 2 to 3. Year classes of 1984 and 1985 had higher values of W and higher absolute growth rates than those of 1986 and 1987. Maximum absolute growth rates of 1986 and 1987 year classes were recorded at younger ages than 1984 and 1985 year classes. The annual relative growth rates of length and weight decreased exponentially with age. Biomass in flesh dry weight increased till spring and thereafter decreased progressively. Maximum biomass was 134.6g m/SUP -2/ in August 1990. The biomass of 1989 yeat class occupied highest proportion in total biomass. Annual production in flesh dry weight from March 1989 to March 1990 was 67.9 g m/SUP -2/ year/SUP -1/. Cumulative production of 1989 year class was highest among all year classes, and that of year class 1984 was lowest. The production is high in spring and autumn, and very low in summer and winter.

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Comparison of Lens Dose in accordance with Bismuth shielding and Patient position in Brain perfusion CT (Brain Perfusion CT에서 Bismuth 차폐와 환자의 자세 변화에 따른 수정체 선량 비교 연구)

  • Gang, Eun Bo
    • Journal of the Korean Society of Radiology
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    • v.12 no.1
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    • pp.47-52
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    • 2018
  • Brain perfusion CT scanning is often employed usefully in clinical conditions as it accurately and promptly provides information about the perfusion state of patients having acute ischemic stroke with a lot of time constraints and allows them to receive proper treatment. Despite those strengths of it, it also has a serious weakness that Lens may be exposed to a lot of dose of radiation in it. In this study, as a way to reduce the dose of radiation to Lens in brain perfusion CT scanning, this researcher conducted an experiment with Bismuth shielding and change of patients' position. TLD (TLD-100) was placed on both lens using the phantom (PBU-50), and then, in total 4 positions, parallel to IOML, parallel to IOML (Bismuth shielding), parallel to SOML, and parallel to SOML (Bismuth shielding), brain perfusion scanning was done 5 times for each position, and dose to Lens were measured. Also, to examine how the picture quality changed in different positions, 4 areas of interest were designated in 4 spots, and then, CT number and noise changes were measured and compared. According to the results of conducting one-way ANOVA on the doses measured, as the significance probability was found to be 0.000, so there was difference found in the doses of radiation to crystalline lenses. According to the results of Duncan's post-hoc test, with the scanning of being parallel to IOML as the reference, the reduction of 89.16% and 89.66% was observed in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding) respectively, so the doses to Lens reduced significantly. Next, in the scanning of being parallel to IOML (Bismuth shielding), the reduction of 37.12% was found. According to the results, reduction in the doses of radiation was found the most significantly both in the scanning of being parallel to SOML and that of being parallel to SOML (Bismuth shielding). With the limit of the equivalent dose to Lens as the reference, this researcher conducted comparison with the dose to occupational exposure and dose to Public exposure in the scanning of being parallel to IOML and found 39.47% and 394.73% respectively; however in the scanning of being parallel to SOML (Bismuth shielding), considerable reduction was found as 4.08% and 40.8% respectively. According to the results of evaluation on picture quality, every image was found to meet the evaluative standards of phantom scanning in terms of the measurement of CT numbers and noise. In conclusion, it would be the most useful way to reduce the dose of radiation to Lens to use shields in brain perfusion CT scanning and adjust patients' position so that their lens will not be in the field of radiation.

Clinical Significance of Hypopharyngeal pH Monitoring in Gastroesophageal Reflux (위식도 역류에 대한 후두인두부에서 산도 검사의 의의)

  • Jeong, Da Woon;Kim, So Hee;Kim, Eun Young;Moon, Kyung Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.8 no.2
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    • pp.143-149
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    • 2005
  • Purpose: The aim of this study was to evaluate the significance of pH monitoring at two levels, hypopharynx and esophagus in gastroesophageal reflux. Methods: 29 patients with pathological gastroesophageal reflux were classified into two groups: Group I had recurrent respiratory symptoms and Group II had not recurrent respiratory symptoms. The ambulatory pH monitoring was performed at the hypopharynx and the esophagus simultaneously with two channel catheter for 18~24 hr. The pathological reflux was defined when the percent of time that pH was below 4.0 exceeding the 95th percentile of normal value. Hypopharyngeal reflux was defined as the pharyngeal pH drops below 4. Results: 39 patients were performed pH monitoring at the level of hypopharynx and esophagus for 24 hours. Among 7 patients with chronic respiratory symptom, 6 patients (85.7%) have pathological esophageal reflux. Among 32 patients without chronic respiratory symptom, 23 patients (71.8%) have pathological esophageal reflux. Thus 29 out of 39 patients (74%) have pathological esophageal reflux. In the Group I, all parameters except the longest episode showed significant differences between hypopharyngeal and esophageal pH monitoring. None of parameters showed significant differences between group I and II in the pharyngeal pH monitoring. Conclusion: Regardless of presence of respiratory symptoms, the pH monitoring at the pharyngeal level in patients with gastroesophageal reflux did not showed any differences compared with the esophageal pH monitoring. Therefore we may reconsider the usefulness of hypopharyngeal pH monitoring in patients with chronic respiratory symptoms.

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Living-Related Liver Transplantation with Heterozygote Carrier Graft in Children with Wilson Disease (윌슨병 환아에서 이형 접합 보인자 공여간을 이용한 혈연간 생체 부분 간이식)

  • Kim, Jin-Taek;Chang, Soo-Hee;Choi, Bo-Hwa;Kim, Kyung-Mo;Yoo, Han-Wook;Lee, Young-Joo;Lee, Sung-Gyu
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.6 no.2
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    • pp.161-166
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    • 2003
  • Purpose: The purpose of this study was to evaluate the efficiency of treatment of living-related liver transplantation (LRLT) with the parental heterozygote carrier graft in children with Wilson disease. Methods: We retrospectively evaluated 7 children with Wilson disease who had received liver transplantation from 1994 to 2002 at Asan Medical Center. All the donors were parental. Liver functions, Kayser-Fleischer ring, and other factors regarding to copper metabolism were analyzed. Results: Of the 7 children, 5 had fulminant hepatitis and 2 had decompensated liver cirrhosis irresponsive to medical therapy. All donors being parental, all grafts came to be heterozygote carrier grafts. Survival rate was 100% in those 7 children, 87% in all children with liver transplantation in the same period, and 84% in children with non-metabolic liver disease. After liver transplantation, all 7 children could stop low copper diet and penicillamine therapy and their AST, total bilirubin and prothrombin time were recovered to normal. After liver transplantation, ceruloplasmin and serum copper levels were also recovered to normal. A marked reduction in 24 hr-urinary copper excretion was observed in all recipients after transplantation. During follow-up, Kayser-Fleischer rings resolved completely after LRLT in 5 children and partially in 1 child. Conclusion: We concluded that living-related liver tranplantation in children with Wilson disease with parental heterozygote carrier graft is an effective treatment modality.

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Parental Survey for Children with Feeding Problems (섭취 문제가 있는 영유아 아동에 대한 부모설문조사)

  • Kim, Hye-Jin;Chung, Kyong-Mee;Park, Mi-Jung;Choe, Yon-Ho
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.11 no.2
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    • pp.179-186
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    • 2008
  • Purpose: Feeding problems are common for typically developing children and have negative effects on physical, behavioral, and cognitive development. The purpose of the current study was to examine factors related to childhood feeding problems for typically developing children via parental reports. Methods: The feeding questionnaire developed by the authors and the Childhood Eating Behavior Inventory (CEBI) were administered to 796 parents of children who recruited from 2 pediatric outpatient clinics (n=379) and community (n=417). Problem eaters (PE) were identified by parental report and frequency analysis was conducted for types of feeding problems and its severity, problem behaviors during mealtime, the feeding methods of the parents, and the need for treatment. Results: The CEBI scores were significantly different between the PE and non-problem eaters (NPE), which suggests that the parental reports were reliable. The younger children had more feeding problems than the older children. The most frequent and severe feeding problems were selective eating and longer mealtimes across all age groups. One-half of the children had more than one problem behaviors during mealtime. Most parents of PE used ineffective methods to deal with children's behaviors during meal time, such as cajoling, which was related to their increased level of stress. Many parents reported their children need professional help for the feeding problems. Conclusion: Feeding problems are prevalent among children, especially younger children. Children with feeding problems showed a number of problem behaviors during mealtime and parental coping methods appeared to be ineffective. The need for treatment was considerable, thus the characteristics of this population must be acknowledged for providing proper treatment and advice.

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Significance of Serum Ferritin in Multiple Trauma Patients with Acute Respiratory Distress Syndrome (다발성 외상 환자에서 발생되는 급성 호흡 곤란 증후군의 예측 인자로서 혈청 페리틴의 의의)

  • Ji, Yae-Sub;Kim, Nak-Hee;Jung, Ho-Geun;Ha, Dong-Yeup;Jung, Ki-Hoon
    • Journal of Trauma and Injury
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    • v.20 no.2
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    • pp.57-64
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    • 2007
  • Purpose: Clinically, acute respiratory distress syndrome (ARDS) occurs within 72 hours after acute exposure of risk factors. Because of its high fatality rate once ARDS progresses, early detection and management are essential to reduce the mortality rate. Accordingly, studies on early changes of ARDS were started, and serum ferritin, as well the as injury severity score (ISS), which has been addressed in previous studies, thought to be an early predictive indicator for ARDSMethods: From March 2003 to March 2005, we investigated 50 trauma patients who were admitted to the intensive care unit in Dongguk University Medical Center, Gyeongju. The patients were characterized according to age, sex, ISS, onset of ARDS, time onset of ARDS, serum ferritin level (posttraumatic $1^{st}\;&\;2^{nd}$ day), amount of transfused blood, and death. Abdominal computed topography was performed as an early diagnostic tool to evaluate the onset of ARDS according to its diagnostic criteria. The serum ferritin was measured by using a $VIDAS^{(R)}$ Ferritin (bioMeriux, Marcy-1' Etoile, France) kit with an enzyme-linked fluorescent assay method. For statistical analysis, Windows SPSS 13.0 and MedCalc were used to confirm the probability of obtaining a predictive measure from the receiver operating characteristics (ROC) curve. Results: The ISS varied from 14 to 66 (mean: 33.8) whereas the onset of ARDS could be predicted with the score above 30 (sensitivity: 90.0%, specificity: 60.0%, p<0.05). On the posttraumatic $1^{st}$ day, the serum ferritin levels were measured to be from 31 mg/dL to 1,200 mg/dL (mean: 456 mg/dL), and the onset of ARDS could be predicted when the value was over 340 mg/dL (sensitivity: 80.0%, specificity: 65.0%, p<0.05). On the posttraumatic $2^{nd}$ day, the serum ferritin levels were measured to be from 73 mg/dL to 1,200 mg/dL (mean: 404 mg/dL), and the onset of ARDS could be predicted when the value was over 627 mg/dL (sensitivity: 60.0%, specificity: 92.5%, p<0.05). The serum ferritin levels and the ISS were significantly higher on the posttraumatic $1^{st}$ and $2^{nd}$ day in the ARDS group, suggesting that they are suitable indices predicting the onset of ARDS, however relationship between the serum ferritin levels and the ISS was not statistically significant. Conclusion: In this study, we discovered increasing serum ferritin levels in multiple- trauma patients on the posttraumatic $1^{st}$ & $2^{nd}$ day and concluded that both the serum ferritin level and the ISS were good predictors of ARDS. Although they do not show statistically significant relationship to each other, they can be used as independent predictive measures for ARDS. Since ARDS causes high mortality, further studies, including the types of surgery and the methods of anesthesia on a large number of patients are essential to predict the chance of ARDS earlier and to reduce the incidence of death.