• 대한핵의학회지
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• 제37권5호
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• pp.336-339
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• 2003

Purpose: A 6-year-old boy with osteogenic sarcoma of the left humerus underwent bone scintigraphy. Tc-99m MDP was accumulated not only in the primary tumor but also in the osseous and extraosseous (pulmonary and pericardial) metastases. Osteogenic sarcoma directly produces osteoid, both in the primary and metastatic lesions. Tc-99m MDP is avidly taken up by tumor osteoid. At initial presentation, only 2% of cases have both pulmonary and osseous metastases. The patient had osseous, pulmonary, and pericardial metastases at presentation. This case presents that increased uptakes of Tc-99m MDP by the primary and metastatic tumor were demonstrated on bone scintigraphy at presentation.

• Tuberculosis and Respiratory Diseases
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• 제55권3호
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• pp.280-286
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• 2003

목 적 : 폐암의 골전이 진단을 위해 흔히 이용하는 골주사는 예민도는 높으나 특이도가 낮아서, 악성 병변과 양성 병변을 구분하는 데에는 유용성이 낮다. 최근 전신 촬영이 가능한 $^{18}FDG$ PET이 암 진단에 널리 이용되고 있으므로 폐암의 골전이를 진단하는데 있어서 골주사와의 차이를 비교하기 위해 후향적 연구를 시행하였다. 방 법 : 폐암으로 진단된 환자 중 골수사와 전신 $^{18}FDG$ PET를 시행한 시간 차이가 1달 이내인 92명을 대상으로 하였다. 골전이의 판정은 골주사와 $^{18}FDG$ PET에서 이상 부위를 단순 X-선, 자기공명영상으로 평가하거나, 추적 영상검사로 확진하였다. 결 과 : 폐암의 골전이를 판정하는데 있어서 골주사의 민감도, 특이도, 정확도는 각각 59%, 71%, 68%이었으며, $^{18}FDG$ PET의 경우 각각 82%, 94%, 91%으로 $^{18}FDG$ PET이 골주사보다 특이도와 정확도에서 유의하게 우월하였다(p<0.0001). 결 론 : 폐암의 골전이를 평가하는데 있어서 $^{18}FDG$ PET은 전통적인 골주사보다 유용한 검사로 생각된다.

• 한국임상수의학회지
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• 제16권2호
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• pp.293-299
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• 1999

Bone scintigraphy with $^{99m}Tc-methylene$ diphosphonate(MDP) performed for 20 weeks per two weeks interval respectively after fracture in seven(male 3 heads, female 4 heads) canine radius were analysed. All of bone scans performed 2 weeks to 20 weeks after fracture showed increase in generalized tracer uptake and showed localized increase in tracer uptake at the fracture site. Bone scans and ratio performed 6 weeks after fracture showed the most outstanding increase in generalized and localized tracer uptake. New bone formation had been observed from 2 weeks and they were incorporated completely on 18 weeks, they showed most activity during 6-10 weeks after fracture. It was recognized that the bone scan with $^{99m}Tc-methylene$ was quite sensitivity but low specificity on the fracture healing in canine radius.

• 대한핵의학회지
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• 제32권2호
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• pp.168-171
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• 1998

We present a case in which a patient with acute hemorrhagic gastritis demonstrated abnormal gastrointestinal accumulation of radiotracer during $^{99m}Tc$-methylene diphosphonate(MDP) skeletal scintigraphy. A hemorrhagic gastritis was subsequently demonstrated by endoscopy. The mechanism for the intestinal localization of $^{99m}Tc$-MDP in this patient is not clear, but we guess that the extravasated blood containing the radiopharmaceutical cannot recirculate and stays at the bleeding site, so we can see the intestinal activity.

• 대한핵의학회지
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• 제33권2호
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• pp.172-177
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• 1999

목적: 핵의학과에서 가장 흔하게 이용되는 골 신티그라피가 인체에 방사선 장해를 일으키는지 아니면 오히려 적응반응을 통하여 유리한 작용을 하는지 여부를 알기 위하여 이 연구를 시행하였다. 대상 및 방법: 골 신티그라피를 시행한 22명의 환자(남자 6명, 여자 16명, 평균 연령 $50{\pm}14$세)를 대상으로 Tc-99m-methylene diphosphonate (Tc-99m-MDP) 주사 전과 주사 후 4시간에 각각 5 ml씩 채혈하여 배양하고 배양 46시간 후에 Cs-137조사기(central dose rate=654 Gy/h, Gammacell 3000 Elan, Nordion, Canada)를 이용하여 2 Gy의 감마 방사선을 조사하였다. 대조군 10명의 혈액을 채혈하여 Tc-99m-MDP 주사전에 채혈한 군과 같은 방법으로 조사하고 배양하였다. Colcemid 처리 2시간 후에 수확하여 세포 600개당 불안정 염색체인 반지형과 이 중 중심체형 염색체의 숫자를 계수하여 각 군 간의 불안정염색체계수를 분산 분석으로 비교하였다. 결과: Tc-99m-MDP를 주사하기 전에 채혈하고 2 Gy를 조사한 군과 대조군에서 2 Gy를 조사한 군의 불안정염색체의 수는 유의한 차이가 없었다(각각 $385.1{\pm}30.5$, $367.8{\pm}36.6$, p>0.05). 하지만 Tc-99m-MDP를 주사한 후에 채혈하고 2 Gy를 조사한 군에서 불안정 염색체의 수가 유의하게 감소하였다($192.6{\pm}22.1$, p=0.0001). 결론: 골 신티그라피에 의한 저선량의 방사선 조사에 의해서 말초혈액 림프구가 적응반응을 나타내어 다음에 이어지는 방사선 장해에 대해 저항성을 갖는 다는 사실을 알 수 있었다.

• 대한핵의학회지
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• 제35권4호
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• pp.291-292
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• 2001

We report a case of malignant pericardial effusion originated from adenocarcinoma of the lung incidentally diagnosed by bone scintigraphy, prior to echocardiographic detection. A 76 year-old man with adenocarcinoma of the lung underwent Tc-99m MDP bone scintigraphy to evaluate skeletal metastasis. Anterior images of the chest of the bone scintigraphy unexpectedly showed diffuse increased activity in the region of the heart surrounded by an oval-shaped band of increased activity corresponding to the periphery of the cardiac silhouette (Fig. 1). There was no evidence of bony metastasis. Pericardial effusion was confirmed by echocardiography (Fig. 2) and malignant cells were revealed by subsequent microscopic examination of the pericardial fluid. Bone scintigraphy using Tc-99m phosphate compounds is commonly used to detect bony metastasis in cancer patients. Tc-99m phosphate compounds occasionally accumulate in extra-osseous sites, including $pleural^{1,2)},\;pericardial^{3,4)},\;and\;ascitic\;fluids^{5,6)}$. It has been reported that their accumulation in serous effusions should strongly suggest $malignancy^{1-6)}$. The exact mechanism for accumulation of Tc-99m phosphate compounds in serous effusions is unclear. Several investigators have proposed that the radiopharmaceuticals exuded directly from peripheral vessels to the serous cavity due to increased vascularity and vascular permeability, and bleeding by disruption of blood vessels due to cancerous $infiltration^{5,6)}$.

• 대한핵의학회지
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• 제34권5호
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• pp.436-437
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• 2000

A 63-year-old male who had subtotal gastrectomy for early gastric cancer three months ago underwent Tc-99m bone scintigraphy for the evaluation of skeletal metastases. He had no symptoms such as fever, tenderness, or wound discharge. On physical examination, the surgical scat along the midline of the upper abdomen had keloid formation and there was no radiographic evidence of calcification. Bone scintigraphy (Fig. 1A & 1B) demonstrated all unusual linear increased uptake along the midline of the upper abdomen that corresponded to the,skin incision for subtotal gastrectomy. Usually, an incisional scar will not be visualized in Tc-99m methylene diphosphate (MDP) scintigraphy beyond two weeks after surgery.$^{1)}$ Upon reviewing the literature, there were only a few reports where localization of Tc-99m MDP in surgical scars were found two months after surgery.$^{2)}$ It was also reported that a few cases with Tc-99m MDP uptake in the keloid scar developed after surgery. Although there are several potential mechanisms that may explain the uptake of Tc-99m MDP in scar tissue, the primary mechanism in older scars is suggested to be a result of pathological calcification.$^{2)}$ Siddiqui et al$^{3)}$ suggested it could be due to microscopic calcification in small resolving hematomas. However, the primary mechanism in keloid scar is not well-known. We should obtain oblique or lateral views to differentiate the uptake in healing surgical scars from the artifactual uptake.

• Nuclear Medicine and Molecular Imaging
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• 제43권4호
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• pp.366-367
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• 2009

Ga-67 scintigraphy demonstrated increased uptake in the lungs and stomach in a 26-year-old man with hypercalcemia. A primitive neuroectodermal tumor was confirmed by bone marrow examination. Tc-99m MDP uptake in the same locations as Ga-67 revealed by bone scintigraphy was consistent with metastatic calcification. Although the mechanism of Ga-67 uptake in metastatic calcification is not understood, the presence of an inflammatory process is suggested.

• 대한핵의학회지
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• 제34권5호
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• pp.433-435
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• 2000

A 6000-year-old male with carcinoma of the prostate and cerebral infarction underwent a Tc-99m MDP bone scintigraphy for the evaluation of skeletal metastases. Bone scintigraphy (Fig. 1) showed multiple areas of increased uptake of Tc-99m MDP in the skull, spine, and ribs representing skeletal metastases. Two different patterns of uptake occurred in the skull region (Fig. 1A-C); one represents bony metastasis and the ether represents cerebral infarction. The shape, size, location, intensity, and border of the increased uptake differed between the two lesions. An oval-shaped pattern with smaller size, greater intensity and more sharply defined border in the frontal region was consistent with bony metastasis. A rectangular-shaped pattern with larger size, lesser intensity and relatively indistinct border in the temporo-parieto-occipital region was consistent with cerebral infarction. Increased uptake of bone-seeking radiotracers in cerebral infarction has been reported previously.$^{1-4)}$ A suggested mechanism by which bone-seeking radiotracers accumulate in the necrotizing cerebral tissue is an alteration of the blood-brain barrier induced during cerebral infarction, which results in entry of the radiotracers into the extracellular space of the brain.$^{4)}$ Brain CT (Fig. 2) performed 7 days before and one month after the bone scintigraphy revealed lesions on the right temporo-parieto-occipital region consistent with acute hemorrhagic and chronic cerebral infarction, respectively.

• 한국임상수의학회지
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• 제20권2호
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• pp.207-211
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• 2003

This investigation aimed to determine the relative merit of osseointegration in immediate and delayed implantation in the dog mandible using radiography and bone scintigraphy. five adult mongrel dogs with a mean weight of 8.5 kg were used in this investigation. During the entire study period. all dogs were fed with a soft commercial diet and water ad libitum to minimize functional loading of the implant. Twenty titanium alloy systems 4 mm in diameter and 10 mm in length blasted with calcium phosphate were prepared for insertion. The second and third left mandibular premolars in each dog were extracted for the delayed implant insertion. Twelve weeks later, the second and third right mandibular premolars were extracted for the immediate implant insertion. Before the delayed and immediate implantation procedures and 0, 4, 8, and 12 weeks after the insertions, radiography and bone scintigraphy were conducted. Bone scans were obtained using a large field of view gamma camera equipped with a collimator about 3 hours after intravenous injection of Tc-99m-MDP to the dogs. All the dogs were evaluated weekly for inflammation, necrosis, and other of the bone or sort tissue. Significant macroscopic lesions were not detected. Radioisotope scintigraphy with Tc-99m-MDP hat proved to be a reliable method for measuring increased bone activity at specific skeleton tissue sites. In conclusion, osseointegration in peri-implant bone did not differ significantly between the immediate and delayed implant procedures during the experimental period. The immediate implant may be an alternative treatment of implant insertion in animals.