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고감도 범용성 콜리메이터를 이용한 소아 환자 99mTc-DMSA 신장 SPECT의 유용성

Clinical Usefulness of 99mTc-DMSA Renal SPECT Using High Sensitivity-All Purpose Collimator for Pediatric Patients

  • 김진의 (동신대학교 방사선학과) ;
  • 김정수 (동남보건대학교 방사선과) ;
  • 한재복 (동신대학교 방사선학과) ;
  • 최남길 (동신대학교 방사선학과)
  • 투고 : 2015.08.19
  • 심사 : 2015.10.23
  • 발행 : 2016.03.28

초록

신장의 기능을 정량분석 할 수 있는 $^{99m}Tc$-DMSA 평면 영상은 단층영상에 비해 병소의 위치 정보에 한계가 있다. 따라서 광자 신호에 민감한 범용성 collimator로 교체하여 SPECT 방식으로 임상실험을 시행한 후, 진단의 정확도와 검사 소요시간을 분석하여 임상적용 가능성을 평가하였다. 10명의 실험대상에게 방사성의약품(1.0-1.2 MBq/kg)을 정맥주사하고, 이중 검출기 감마카메라를 이용하여 planar scan (high resolution (HR)-mode, $256{\times}256$, 50 kcts/view, 4 image)과 SPECT (HR / high sensitive (HS)-mode, $128{\times}128$, step and shoot, $180^{\circ}$, variable sec/angle, total 64 frame, OSEM reconstruction)를 시행하였다. 획득한 데이터를 분석 프로그램을 이용하여 비교한 결과, 실험 방법에 따라서 total counts는 high sensitive-mode SPECT가 대략 1.8-5.6 배 정도 많았고, counts를 이용한 상대신장기능은 모든 실험에서 유의한 수준 범위에서 차이가 없었으며(p=0.96), 검사 소요시간은 39%정도 단축되었다. 그러므로 고감도 범용성 collimator를 이용한 $^{99m}Tc$-DMSA renal SPECT는 planar scan에 비하여 신장의 기능을 정량분석 할 수 있고, 병변의 위치에 대한 정보를 보다 정확하게 진단할 수 있으며, 동시에 검사 소요시간을 단축시킬 수 있으므로 임상적으로 유용하게 활용할 수 있을 것으로 사료된다.

$^{99m}Tc$-DMSA planar scan that can analyze the functions of kidney quantitatively provides less information on a lesion than tomography scanning. Therefore, this study applied a high sensitivity all-purpose collimator that is sensitive to photonic signals to $^{99m}Tc$-DMSA and carried out a clinical scan with single photon emission computed tomography (SPECT). And diagnostic accuracy and time requirement of were analyzed to know the clinical usefulness of the applied scanning method. 10 subjects were intravenously injected with radiopharmaceutical product (1.0-1.2 MBq/kg) and scanned by a gamma camera with planar scanner (high resolution (HR)-mode, $256{\times}256$, 50 kcts/view, 4 image) and SPECT (HR / high sensitive (HS)-mode, $128{\times}128$, step and shoot, $180^{\circ}$, variable sec/angle, total 64 frame, OSEM reconstruction), respectively. The collected data was compared with an analysis program. The results showed that HS-mode SPECT detected total counts 1.8-5.6 times more than planar scan. Relative renal function evaluated based on the counts was not significantly different by two scanning methods (p=0.96) and it turned out that test time was shortened by 39% when HS-mode SPECT was used. Therefore, SPECT using HR, HS-mode collimator could analyze renal function more quantitatively than using planar scan and the former could diagnose the location information of a lesion more accurately than the latter as well as shortened test time requirement, which demonstrated the clinical usefulness of $^{99m}Tc$-DMSA renal SPECT using high sensitivity all purpose collimator.

키워드

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