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The Usefulness of Visceral Fat Thickness Measured by Ultrasonography as an Abdominal Obesity Index (초음파로 측정된 내장지방두께의 복부 비만지표로서의 유용성)

  • Kim, Yong-Kyun;Han, Man-Seok
    • Journal of radiological science and technology
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    • v.31 no.3
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    • pp.249-258
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    • 2008
  • Purpose : Abdominal obesity with visceral fat accumulation have been known to be intimately associated with the development of metabolic syndrome. Therefore, it is important to estimate the precise amount of visceral fat. Ultrasonography has been reported that it is a simple and noninvasive method for visceral fat evaluation. Purpose of this study is to evaluate the association of ultrasonographic visceral fat thickness, anthropometric indexes, and risk factor of metabolic syndrome, and to investigate the cut-off value of abdominal visceral fat thickness leading to increased risk of metabolic syndrome. Materials and methods : The subject included 200 men and 200 women who visited D healthcare center in Daejeon from January to April 2008. The subcutaneous fat thickness and visceral fat thickness were measured by ultrasonograph. As anthropometric index, we measured body mass index, waist circumference and waist/height ratio. As for the risk factor of metabolic syndrome, we measured blood pressure, high density lipoprotein cholesterol, triglyceride and fasting serum glucose. Results : VFT was significantly correlated with waist circumference, (r=0.683/M, r=0.604/F), waist to height ratio (r=0.633/M, r=0.593/F) and BMI (r=0.621/M, r=0.534/F) in both men and women. In addition it was significantly correlated with Systolic blood pressure (r=0.229/M, r=0.232/F), Diastolic blood pressure ((r=0.285/M, r=0.254/F), high density cholesterol (r=-0.254/M, r=-0.254/F), Triglyceride (r=0.475/M, r=0.411/F), and Fasting blood sugar (r=0.158/M, r=0.234/F) in both men and women. The cut-off value of visceral fat thickness leading to the increased risk of metabolic syndrome was 4.58cm (sensitivity89.2%, specificity 71.2%) in men and 3.50cm (sensitivity61.2% specificity 80.8%) in women respectively. The odds ratio of the risk of metabolic syndrome was dramatically increased with the abdominal visceral fat thickness level over 6cm in men and 5cm in women. Conclusion : The visceral fat thickness using ultrasonography was significantly correlated with anthropometric indexes and risk factors of metabolic syndrome in both men and women. The cut-off value of visceral fat thickness leading to the increased risk of metabolic syndrome was 4.58cm in men and 3.50cm in women.

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Normal Corpus Callosum Dimensions Measured by MRI (MR Midsagittal 영상을 이용한 정상 뇌량의 크기 측정)

  • Kim, Ham-Gyum
    • Journal of radiological science and technology
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    • v.31 no.3
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    • pp.277-285
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    • 2008
  • As a result of measuring the size of corpus callosum in normal Korean people by using MRI, the following conclusions were obtained. 1. Maximum, minimum, and mean values by the region in whole subjects 1) Anteroposterior length amounted to the mean with 69.30mm, the minimum with 50.70mm, and the maximum with 80.40mm. 2) Diameter of genu amounted to the mean with 11.93mm, the minimum with 6.00mm, and the maximum with 18.50mm. 3) Diameter of mid body amounted to the mean with 7.00mm, the minimum with 3.40mm, and the maximum with 10.40mm. 4) Diameter of narrowing portion amounted to the mean with 4.51mm, the minimum with 0.80mm, and the maximum with 9.50mm. 5) Diameter of splenium amounted to the mean with 12.17mm, the minimum with 6.90mm, and the maximum with 17.20mm. 2. Comparison by region according to the gender in the whole subjects 1) Anteroposterior length was bigger in men than in women, and showed the significant difference depending on gender. 2) Diameter of genu, diameter of mid body, and diameter of narrowing portion were bigger in men than in women, but there was no significant difference. 3) Diameter of splenium was bigger in men than in women, and showed the statistically significant difference. 3. Comparison by region according to the age in the whole subjects 1) Anteroposterior length was the biggest in the 50s at the age, and was smaller in heir 10s than other age levels. In addition, the significant difference was indicated depending on age. 2) Diameter of genu and diameter of mid body were the biggest in their 30s, and were smaller in the 60s than other age levels. And, the statistically significant difference was indicated. 3) Diameter of narrowing portion was the thickest in their 20s, and was thinner in their 60s than other age levels. And, the significant difference was indicated depending on age. 4) Diameter of splenium was the thickest in their 30s, and was thinner in their 10s than other age levels. And, the statistically significant difference was indicated. 4. Correlation by region in whole subjects 1) Diameter of genu showed the statistically significant positive correlation with anteroposterior length. 2) Diameter of mid body showed the statistically significant positive correlation with anteroposterior length and diameter of genu. 3) Diameter of narrowing portion didn't show the statistically significant correlation with anteroposterior length, but showed the statistically significant positive correlation with diameter of genu and diameter of mid body. 4) Diameter of splenium showed the statistically significant positive correlation with anteroposterior length, diameter of genu, diameter of mid body, and diameter of narrowing portion.

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The Evaluation of Radioimmunoassay kits for Insulin (Insulin 측정용 방사면역측정법 시약의 평가)

  • Shin, Yong Hwan;Kim, Yun Hyun;Lee, Il Kyu;Kim, Ji Young;Seok, Jae Dong;Shin, Suk Hee
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.149-155
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    • 2012
  • Purpose : Serum insulin levels are useful indicator which of reflecting the function of insulin secretion in pancreatic ${\beta}$ cell and diagnosis of diabetes, differentiating the cause of impaired glucose tolerance. Insulin measurement kits have shown some differences in many ways such as test methods as well as quality control. The purpose of this study was to evaluate the diagnostic performance of seven manufacturing companies commercial kits. Materials and Methods : The values of insulin measured by three manufacturing companies (Biosource, Siemens, TFB) with 59 samples in August 2009 were compared with those measured by four manufacturing companies (Immunotech, Izotope, BNIBT, Cisbio) with 68 samples in December 2011. We evaluated precision, recovery rate, dilution test and correlation of serum insulin measurement using seven manufacturing company kits. Statistical program SPSS 12.0 was used for the verification of results. Results : The coefficients variation of the precision on all seven different kits were showed within 5.0%. Recovery rate of Biosource, Siemens, TFB kits on three different levels showed 94.2~103.7%, 99.0~104.6%, 99.7~107.6% respectively. Immunotech, Izotope, BNIBT, Cisbio were 93.5~99.1%, 91.4~99.1%, 99.2~131.0%, 84.8~102.3% respectively. There was strong correlation between the measurement of insulin by Biosource kit and that by two commercial kits, Siemens (R2=0.96), TFB (R2=0.99). There was good correlation between the measurement of insulin by TFB kit and that by three commercial kits, Immunotech (R2=0.97), Izotope (R2=0.96), Cisbio (R2=0.97). In the dilution test performed with more than 200 ${\mu}IU/ml$ high concentration samples, samples with diabetes correctly was measured in all seven manufacturing kits. However, as measured with insulinoma samples TFB, Siemens, Izotope, Cisbio kits were correctly measured, but Biosource and Immunotech kits were measured 47.4 ${\mu}IU/ml$, 72.3 ${\mu}IU/ml$, respectively. Conclusion : Serum Insulin radioimmunoassay kits were showed excellent precision, correlation and good recovery rate. However, some kits were not measured correctly in the high concentration insulin values. when selecting a kit should be considered many factors that cost effectiveness, compatible for automation equipment, high performance kit, the environment for each laboratory such as reaction time and reporting time.

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Effect of Contrast-Enhanced $^{18}F$-FDG PET/CT on Measurements of Whole Body Bone Mineral Density and Body Composition by Dual-Energy X-Ray Absorptiometry (조영증강 $^{18}F$-FDG PET/CT가 이중에너지 X-선 흡수 계측법을 이용한 골밀도 및 체성분 측정에 미치는 영향)

  • Kim, Seong Su;Lee, Sun Do;Lee, Nam Ju;Shin, Yong Cheol;Mo, Eun Hee;Lee, Chun Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.7-11
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    • 2012
  • Purpose : The effect of concomitant use of $^{18}F$-FDG and intravenous contrast agent (CA) on dual-energy X-ray absorptiometry (DXA), was rarely reported. We had investigated these potentially confounding effects. Materials and Methods : Twenty-two patients had undergone DXA before and immediately after $^{18}F$-FDG PET/CT scans. Two DXA and 1 PET/CT scans had performed within one-day. $^{18}F$-FDG PET/CT scans had been performed with CA in 17 patients and without CA in 5 patients. Whole body bone mineral content (BMC), whole body bone mineral density (BMD), total fat mass (TFM), and lean body mass (LBM) were measured by DXA scanner before and after the $^{18}F$-FDG PET/CT scans. Results : BMC, BMD, TFM and LBM had significantly affected by $^{18}F$-FDG PET/CT with CA (BMC, +13.7%, from $2061.3{\pm}393.7$ to $2343.4{\pm}373.3$; BMD, +9.3%, from $1.07{\pm}0.09$ to $1.17{\pm}0.08$; TFM, -34.1%, from $17052.1{\pm}4049.9$ to $11237.1{\pm}2990.3$; LBM, +13.6%, from $45834.5{\pm}5662.1$ to $52094.0{\pm}6335.4$). However, $^{18}F$-FDG PET/CT without CA had no effect on the measurement of DXA (BMC, +2.4%, from $2197.7{\pm}391.6$ to $2251.5{\pm}380.9$; BMD, +1.8%, from $1.13{\pm}0.09$ to $1.15{\pm}0.07$; TFM, -6.8%, from $14585.6{\pm}3455.9$ to $13591.3{\pm}4351.4$; LBM, +2.2%, from $47360.5{\pm}8381.8$ to $48441.1{\pm}8488.1$). Conclusion : The measurements of DXA are affected by using CA. However, DXA scans might be unaffected by the presence of $^{18}F$-FDG administered for PET/CT.

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Study on Overcoming Interference Factor by Automatic Synthesizer in Endotoxin Test (내독소 검사에서 자동합성장치에 따른 간섭요인 극복에 대한 연구)

  • Kim, Dong Il;Kim, Si Hwal;Chi, Yong Gi;Seok, Jae Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.3-6
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    • 2012
  • Purpose : Samsung medical ceter shall find a cause of the interference factor and suggest a solution for it. Materials and Methods : A sample of $^{18}F$-FDG, radioactive pharmaceuticals produced by TRACERlab MX and FASTlab synthesizer. Gel-clot method uses Positive control tube and single test tube. Kinetic chromogenic method uses ENDOSAFE-PTS produced by Charles River. Results : According to Gel clot method of Endotoxin Tests at FASTlab, both turbidity and viscosity increased at 40-fold dilution and Gel clot was detected. In case of TRACERlab MX, Gel clot was detected in most of samples but intermittently not in a few of them. When using ENDOSAFE-PTS, sample CV (Coefficient of Variation) of FASTlab is 0% at all dilution rates whereas spike CV is 0% at 1-fold dilution, 0~35% at 10-fold, 3.6~12.9% at 20-fold, 5.2~7.1% at 30-fold, 1.1~17.4% at 40-fold, spike recovery; 0% at one-fold, 25 ~ 58% at 10-fold, 50 ~ 86% at 20-fold, 70~92% at 30-fold, and 75~120% at 40-fold. Sample CV of TRACERlab MX, is 0% at all dilution rates whereas spike CV is 1.4~4.8% at one-fold dilution, 0.6~19.9% at 10-fold, spike recovery; 35~72% at one-fold dilution and 77~107% at 10-fold. Conclusion : Gel clot does not seem to occur probably to H3PO4 which engages in bonding with Mg2+ion contributing gelation inside PCT. Dilution which is identical to reducing the amount of H3PO4, could remove interfering effects accordingly. Spike recovery was obtained within 70~150% - recommended values of supplier - at 40-fold dilution even in kinetic chromogenic method.

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Correction of Artifacts due to Patient Arm Motion in PET/CT: Scatter-Limit Correction (PET/CT 검사에서 움직임에 의한 인공물의 산란제한보정법 적용 영상 평가)

  • Bahn, Young Kag;Lee, Seung Jae;Kim, Jung Yul;Oh, Sin Hyun;Nam-Koong, Hyuk;Park, Hoon-Hee;Kang, Chun Koo;Lim, Han Sang;Lee, Chang Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.16 no.2
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    • pp.44-48
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    • 2012
  • Purpose : Arm motion can give rise to striking cold artifact on PET/CT. We investigated that evaluation of scatter-limit correction and correct the patient arm motion artifact in Discovery 600 PET/CT. Materials and Methods : To evaluate a radioactivity uptake (Bq/ml) and a standard uptake value (SUV), the scatter limit correction and scatter correction were compared using 1994 NEMA Phantom$^{TM}$ in Discovery 600 PET/CT (GE Healthcare, Mi, We). Arm motion phantom study was involved a central 20 cm diameter cylinder simulating the neck and 2 peripheral 10 cm diameter cylinders simulating arms. The positions of the arms were altered so as to introduce different amounts of misalignment. The evaluation of arm motion phantom study used the radioactivity uptake and SUV in scatter correction and scatter limit correction. Results : The statistical significance of radioactivity uptake and SUV did not show the differences in comparisons of the scatter limit correction and the scatter correction that not show (p<0.05). Radioactivity uptake of the scatter correction was up to 3.1 kBq/ml in the 0.04 kBq/ml. It was approximately 98.7% undervalued in the arm motion phantom study. However, Radioactivity uptake of the scatter limit correction was up to 3.0 kBq/ml in the 2.11 kBq/ml. It was approximately 30% undervalued in arm motion phantom study. SUV of the scatter correction was 1.05 to 0.006 and underestimated about 98%. However, an applying SUV of the scatter limit correction changed the value as 0.67 which is underestimated about 25%. Radioactivity uptake and SUV of the scatter limit correction was increased approximately 60%, or more than the scatter correction. Conclusion : It is considered that if the patient arm motion artifact was occurred the scatter limit correction will be applicable to give an accurate diagnosis.

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Establishment of Reference Value of Insulin Using the Statistical Analysis (통계적 분석을 통한 Insulin의 정상 참고치 설정)

  • Kim, Whe-Jung;Yoon, Pil-Young;Shin, Young-Goon;Yoo, Seon-Hee;Cho, Shee-Man
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.143-146
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    • 2010
  • Purpose: Insulin is involved in carbohydrate metabolism and also it's very important because it increases storage of glycogen, synthesis of fatty acids, absorption of amino acid, synthesis of protein. Insulin is clinically useful when we evaluate fasting patients in hypoglycemia, classify and predict diabetes, assess the activity of ${\beta}$-cell, research insulin resistance. We are going to increase usability of insulin assay by establishing normal reference value according to statistical analysis. Material & Method: We selected 6,648 patients who visited asan health medical center from May to August in 2008. We set exclusion criteria as family of diabetes, diabetes medication, the past history of blood glucose rise, more than 100 mg/dL in normal fasting blood glucose, outside the scope of BMI 18.5~22.9 $kg/m^2$, and more than HbA1c 6.5%. We determine whether the subgroup is portioned as sex and age or not and establish normal reference value by conducting statistical analysis as Bayesian's method and Hoffman's method. Result: Portioning of subgroup as sex and age is not needed. By statistical analysis of Bayesian method, results 1.5-11.0 uIU/mL. By statistical analysis of Hoffman method, results 1.8~12.8 uIU/mL. Conclusion: We established 1.8~12.8 uIU/mL as Insulin normal reference value by Hoffman method. This is a similar value with reporting reference value 1.7~11.8 uIU/mL in kit. This will enhance the usability of insulin assay by establishing normal reference value.

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The Application of Dynamic Acquisition with Motion Correction for Static Image (동적 영상 획득 방식을 이용한 정적 영상의 움직임 보정)

  • Yoon, Seok-Hwan;Seung, Jong-Min;Kim, Kye-Hwan;Kim, Jae-Il;Lee, Hyung-Jin;Kim, Jin-Eui;Kim, Hyun-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.46-53
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    • 2010
  • Purpose: The static image of nuclear medicine study should be acquired without a motion, however, it is difficult to acquire static image without movement for the serious patients, advanced aged patients. These movements cause decreases in reliability for quantitative and qualitative analysis, therefore re-examination was inevitable in the some cases. Consequently, in order to improve the problem of motion artifacts, the authors substituted the dynamic acquisition technique for the static acquisition, using motion correction. Materials and Methods: A capillary tube and IEC body phantom were used. First, the static image was acquired for 60 seconds while the dynamic images were acquired with a protocol, 2 sec/frame${\times}$30 frames, under the same parameter and the frames were summed up into one image afterwards. Also, minimal motion and excessive motion were applied during the another dynamic acquisition and the coordinate correction was applied towards X and Y axis on the frames where the motion artifact occurred. But the severe blurred images were deleted. Finally, the resolution and counts were compared between the static image and the summed dynamic images which before and after applying motion correction, and the signal of frequency was analysed after frequency spatial domain was transformed into 2D FFT. Supplementary examination, the blind test was performed by the nuclear medicine department staff. Results: First, the resolution in the static image and summed dynamic image without motion were 8.32 mm, 8.37 mm on X-axis and 8.30 mm, 8.42 mm on Y-axis, respectively. The counts were 484 kcounts, 485 kcounts each, so there was nearly no difference. Secondly, the resolution in the image with minimal motion applying motion correction was 8.66 mm on X-axis, 8.85 mm on Y-axis and had 469 kcounts while the image without motion correction was 21.81 mm, 24.02 mm and 469 kcounts in order. So, this shows the image with minimal motion applying motion correction has similar resolution with the static image. Lastly, the resolution in the images with excessive motion applying motion correction were 9.09 mm on X-axis, 8.83 mm on Y-axis and had 469 kcounts while the image without motion correction was 47.35 mm, 40.46 mm and 255 kcounts in order. Although there was difference in counts because of deletion of blurred frames, we could get similar resolution. And when the image was transformed into frequency, the high frequency was decreased by the movement. However, the frequency was improved again after motion correction. In the blind test, there was no difference between the image applying motion correction and the static image without motion. Conclusion: There was no significant difference between the static image and the summed dynamic image. This technique can be applied to patients who may have difficulty remaining still during the imaging process, so that the quality of image can be improved as well as the reliance for analysis of quantity. Moreover, the re-examination rate will be considerably decreased. However, there is a limit of motion correction, more time will be required to successfully image the patients applying motion correction. Also, the decrease of total counts due to deletion of the severe blurred images should be calculated and the proper number of frames should be acquired.

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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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Usability Research of Onco Flash in SPECT (SPECT 검사에서 Onco Flash의 유용성과 질적 향상 평가)

  • Noh, Ik-Sang;Cha, Eun-Sun;Kim, Ki;Choi, Choon-Ki;Suk, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.3-8
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    • 2009
  • Purpose: Onco flash shortens a scan time with half and there is a possibility of getting the data which corresponds in existing. The experiment which makes the image whose Onco Flash is excellent OSEM tried, as changes parameter of time, iteration. After reconstituting an image, produces FWHM and executes an evaluation. Materials and Methods: Siemens e.cam gamma camera, standard Jaszczak phantom and spatial resolution phantom was used. In order for the bubble not to enter, implants 2 mCi and volume 0.25 cc $^{99m}Tc$ respectively in line 3 to spatial resolution phantom. Put on that phantom on the table correctly, and acquires an image. 15 mCi putting in distilled water to mix $^{99m}Tc$ well in Jaszczak phantom and acquires image just like spatial resolution phantom. Reconstructs and converts the image to digital image as Sante program. Produce FWHM and evaluate by Amide. Results: The non-scattered image shows better FWHM value than scattered image. As time increases from 10 sec to 30 sec for 5sec interval, FWHM appeared to 30.1, 28.5, 24.5, 23.6, 23.4 mm. At the standard iteration value 4, OSEM FWHM shows 8.0 mm, and Onco Flash is 8.1 mm. As fade in iteration, FWHM value more and more decreased. Conclusion: When using Onco Flash, shortens a scan time, and enhances image quality. Also, user can adjust the parameters to improve resolution. Therefore, patient and user are satisfied with these merits.

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