• The Korean Journal of Nuclear Medicine
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• v.38 no.6
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• pp.492-497
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• 2004

Purpose: it is very important to differentiate breast cancer from benign mass. There are many reports to evaluate the differential diagnosis under the several diagnostic tools. We evaluated the usefulness of mammography and Tc-99m MIBI scintimammography in the differential diagnosis of breast mass and correlated with pathologic findings. Materials and Methods: This study included 80 patients (a8e: 24-72, mean: 48.4) who underwent mammography and Tc-99m MIBI scintimammography for breast masses. Scintimammographies (anterior-posterior and lateral projections) were acquired in 10 minutes and 2 hours after intravenous injection of Tc-99m MIBI. four specialists in diagnostic radioloay and nuclear medicine evaluated the findings of breast masses under the mammography and Tc-99m MIBI scintimammography, and calculated the tumor to background (T/B) ratio. The pathologic results were obtained and we statistically analyzed the correlations between pathologic results and imaging findings under the mammography and Tc-99m MIBI scintimammography by chi-square and correlation test. Results: The sensitivity, specificity, positive predictive value, and negative predictive value of mammography for detection of breast cancer were 87.5%, 56.3%, 75.0%), and 75.0% respectively. 45 cases of 80 patients were suspicious for breast cancer under the Tc-99m MIBI scintimammography. 41 cases of 45 patients were confirmed as breast cancer and the remaining 4 cases were confirmed as benign masses. The sensitivity, specificity, positive predictive value and negative predictive value of Tc-99m MIBI scintimammography for detection of breast cancer were 85.4%, 87.5%, 91.1%, and 80.8% respectively. The sensitivity of scintimammography was lower than that of mammography for detection of breast cancer, however the specificity, positive predictive value, and negative predictive value were higher. In the benign mass, the mean T/B ratio in 10 minutes was $1.409{\pm}0.30$, and that in 2 hours was $1.267{\pm}0.42$. The maximal T/B ratio of benign mass in 10 minutes was $1.604{\pm}0.42$, and that in 2 hours was $1.476{\pm}0.50$. In the malignant mass, the mean T/B ratio in 10 minutes was $2.220{\pm}1.07$, and that in 2 hours was $1.842{\pm}0.75$. The maximal T/B ratio of malignant mass was $2.993{\pm}1.94$, and that in 2 hours was $2.480{\pm}1.34$. And the T/B ratio under the early and delayed images were meaningful. Conclusion: The scintimammography is useful diagnostic tool to differentiate breast cancer from benign mass, although the sensitivity of mammography for detection of breast mass is high. Especially, the use of the T/B ratio is helpful to diagnose breast cancer.

• The Korean Journal of Nuclear Medicine
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• v.30 no.1
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• pp.104-111
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• 1996

We did Tc-99m sestamibi myocardial perfusion SPECT in 36 patients with acute myocardial infarction when they arrived at the emergency room. And we compared myocardial perfusion images with ECG findings. Then we obtained the follows. The myocardial infarction by the obstruction of left coronary descending artery and right coronary artery showed a good concordance in the diagnosis and infarction site between myocardial perfusion images and ECG findings. The 7 patients with myocardial infarction by a left circumflex coronary artery showed a perfusion defect in the lateral wall in myocardial perfusion SPECT images. But 4 patients of them showed ST segment elevation, 2 patients showed ST depression and 1 patient showed normal ECG findings. The diagnostic sensitivity of Tc-99m sestamibi myocardial perfusion SPECT was 100% by a qualified analysis. The perfusion defect site in the myocardial perfusion SPECT were corresponded with the infarct related coronary artery in 31 patients which was diagnosed by coronary angiograpy. The size of perfusion defect in the po1ar map was $31{\pm}18%(M{\pm}SD)$, in the myocardial infarction with left anterior descending coronary arery obstruction, $31{\pm}13% (M{\pm}SD)$ in the myocardial infarction with right coronary artery obstruction and $25{\pm}5.9%(M{\pm}SD)$ in the myocardial infarction with left circumflex coronary artery obstruction. We concluded that emergency myocardial perfusion SPECT images are useful in the diagnose of myocardial infarction and it's very useful when we are difficult to diagnose with ECG like as lateral wall infarction or left bundle branch block.

• The Korean Journal of Nuclear Medicine
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• v.15 no.2
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• pp.11-17
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• 1981

Cholescintigraphic studies with $^{99m}Tc-HIDA$(dimethyl iminodiacetic acid) were performed in 22 cases of normal subjects, 21 of acute cholecystitis, 12 of chronic cholecystitis and 12 others, with the results of, 1) In normal control group, liver and intrahepatic biliary tree, CBD and gall bladder, and G-I tract appeared at 10, 20 and 30 minutes after intravenous injection of $^{99m}Tc-HIDA$ respectively, 2) In acute cholecystitis, 20 among 21 cases showed non-visualization of gall bladder with the diagnostic accuracy, sensitivity and specificity of 93.2%, 95.2% and 100% respectively. 3) In chronic cholecystitis, 5 among 12 cases showed non-visualization of gall bladder and remained 7 among 12 cases showed poor contraction of gall bladder (4), delayed visualization of gall bladder (1) and normal findings (2). 4) In the other disease group, the 12 cases which initially suspected as acute cholecystitis, revealed normal scan findings to exclude the cystic duct obstruction easily, With the above results, this scintigraphic procedure was found very rapid, accurate and easily available method for the determining of the cystic duct patency.

• The Korean Journal of Nuclear Medicine
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• v.29 no.1
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• pp.9-14
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• 1995

뇌졸증환자의 뇌 SPECT 소견상 나타나는 소뇌교차해리현상(crossed cerebellar diaschisis)은 잘 알려진 현상이다. 한편 간질 환자의 발작시 뇌 SPECT에서 반대편 소뇌에 혈류증가를 보이는 역교차해리현상(reverse type of crossed cerebellar diashisis)은 드물게 보고되었었다. 따라서 본 저자들은 발작시 뇌 SPECT에서 역교차해리현상의 빈도 및 간질병소를 찾는데 있어서의 유용성에 대해 알아보고자 하였다. 복합부분발작환자 중 임상적, 뇌파검사상 및 SPECT 소견등에서 간질병소가 일치하는 12명의 환자를 대상으로 하였다. 환자 모두에서 시행한 발작시 스캔은 발작중 혹은 환자가 aura를 호소할때 $^{99m}Tc$-HMPAO 15-20mCi를 정맥주입 후 시행하였으며 발작간 스캔은 11명의 환자에서 발작시 스캔 후 적어도 3일 간격을 두고 시행하였다. 간질병소는 우측측두엽이 6예, 좌측측두엽이 4예, 우측후두엽이 1예, 좌측전두엽이 1예 등이었다. 발작시 스캔상 간질병소 및 반대편 소뇌에 혈류가 증가하는 역해리현상은 모두 8명(75%)의 환자에서 나타났으며 특히 2명의 환자에서는 간질병소보다 반대편 소뇌의 동위원소 섭취가 더욱 뚜렸했다. 역해리현상을 보였던 환자의 발작간 스캔소견에서는 발작시 증가되었었던 소뇌의 동위원소 섭취가 7예에서 정상화되었고 나머지 1예에서는 감소되었다. 따라서 소뇌의 역교차해리현상은 발작시 뇌 SPECT의 자주 볼 수 있는 현상으로 간질병소의 편측화에 도움을 줄 수 있을 것으로 생각된다.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.2
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• pp.20-24
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• 2019

Purpose Molecular Breast Imaging (MBI) scan is used in nuclear medicine, for which $^{99m}Tc-sestaMIBI$ is administered by intravenous injection. However, the breast uptake rate of $^{99m}Tc-sestaMIBI$ is less than 1% of the total dose administered, relying on blood flow conditions of organs. The purpose of this study is to evaluate the impact of changes to body temperature on the uptake of $^{99m}Tc-sestaMIBI$ in breast tissue. Materials and Methods We investigated 30 breast cancer patients who performed more than one follow-up MBI scan. All scans were acquired by Discovery 750B (Genral Electric Healthcare, USA). $^{99m}Tc-sestaMIBI$ injected with 740 MBq (20 mCi), after 60 minutes, gained bilateral breast CC (CranioCaudal), MLO (Medio Lateral Oblique) View. The follow-up examination was then classified into 15 body temperature control group and 15 body temperature non-control group, and gained breast image in the same way as before. The breast uptake rate was analyzed in the MLO View of the opposite side of the lesion, and blind images were evaluated. Results The breast uptake rate increased by 30.31% in the body temperature control group and it was statistically significant(P<0.05), and 0.96% in the body temperature non-control group, and it was not statistically significant(P=0.955). There was a significant difference in the uptake rate between the body temperature control and the non-control group of P value of 0.01. Evaluation of blind images showed significant results in terms of the quality of the images. Conclusion Increased breast tissue uptake was observed when the subject was kept warm. When the body temperature was raised after injection, dilation of the peripheral blood vessels can be achieved. As a result, the blood flow became smooth and the breast uptake rate increased. In addition, an increase in breast tissue uptake will improve the quality of images.

• The Korean Journal of Nuclear Medicine
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• v.35 no.2
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• pp.89-99
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• 2001

Purpose: In this study, we developed a new software tool for the analysis of renal scintigraphy which can be modified more easily by a user who needs to study new clinical applications, and the appropriateness of the results from our program was studied. Materials and Methods: The analysis tool was programmed with IDL5.2 and designed for use on a personal computer running Windows. For testing the developed tool and studying the appropriateness of the calculated glomerular filtration rate (GFR), $^{99m}Tc$-DTPA was administered to 10 adults in normal condition. In order to study the appropriateness of the calculated mean transit time (MTT), $^{99m}Tc-DTPA\;and\;^{99m}Tc-MAG3$ were administered to 11 adults in normal condition and 22 kidneys were analyzed. All the images were acquired with ORBITOR. the Siemens gamma camera. Results: With the developed tool, we could show dynamic renal images and time activity curve (TAC) in each ROI and calculate clinical parameters of renal function. The results calculated by the developed tool were not different statistically from the results obtained by the Siemens application program (Tmax: p=0.68, Relative Renal Function: p:1.0, GFR: p=0.25) and the developed program proved reasonable. The MTT calculation tool proved to be reasonable by the evaluation of the influence of hydration status on MTT. Conclusion: We have obtained reasonable clinical parameters for the evaluation of renal function with the software tool developed in this study. The developed tool could prove more practical than conventional, commercial programs.

• The Korean Journal of Nuclear Medicine
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• v.39 no.1
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• pp.34-43
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• 2005

Purpose: $^{99m}Tc$-sestamibi(MIBI) and $^{99m}Tc$-tetrofosmin have been used as substrates for P-glycoprotein (Pgp) and multidrug resistance associated protein (MRP), which are closely associated with multidrug resistance of the tumors. To understand different handling of radiotracers in cancer cell lines expressing Pgp and MRP, we compared cellular uptakes of $^{99m}Tc$-MIBI and $^{99m}Tc$-tetrofosmin. The effects of cyclosporin A (CsA), well-known multidrug resistant reversing agent, on the uptake of both tracers were also compared. Materials and Methods: HCT15/CL02 human colorectal cancer cells for Pgp expressing cells, and human non-small cell lung cancer A549 cells for MRP expressing cells, were used for in vitro and in vivo studies. RT-PCR, western blot analysis and immunohistochemistry were used for detection of Pgp and MRP. MDR-reversal effect with CsA was evaluated at different drug concentrations after incubation with MIBI or tetrofosmin. Radioactivities of supernatant and pellet were measured with gamma well counter. Tumoral uptake of the tracers were measured from tumor bearing nude mice treated with or without CsA. Results: RT-PCR, western blot analysis of the cells and irnrnunochemical staining revealed selective expression of Pgp and MRP for HCY15/CL02 and A549 cells, respectively. There were no significant difference in cellular uptakes of both tracers in HCT15/CL02 cells, but MIBI uptake was slightly higher than that of tetrofosmin in A549 cells. Co-incubation with CsA resulted in a increase in cellular uptakes of MIBI and tetrofosmin. Uptake of MIBI or tetrofosmin in HCT15/CL02 cells was increased by 10- and 2.4-fold, and by 7.5 and 6.3-fold in A549 cells, respectively. Percentage increase of MIBI was higher than that of tetrofosmin with CsA for both cells (p<0.05). In vivo biodistribution study showed that MIBI (114% at 10 min, 257% at 60 min, 396% at 240 min) and tetrofosmin uptake (110% at 10 min, 205% at 60 min, 410% at 240 min) were progressively increased by the time, up to 240 min with CsA. But increases in tumoral uptake were not significantly different between MIBI and tetrofosmin for both tumors. Conclusion: MIBI seems to be a better tracer than tetrofosmin for evaluating MDR reversal effect of the modulators in vitro, but these differences were not evident in vivo tumoral uptake. Both MIBI and tetrofosmin seem to be suitable tracers for imaging Pgp- and MRP-mediated drug resistance in tumors.

• The Korean Journal of Nuclear Medicine
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• v.19 no.2
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• pp.93-95
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• 1985

A simple imaging procedure has been devised for patients with peritoneo-venous shunts when ascites reaccumulates and a decision must be made on whether or not to revise the shunt. We recently experienced a patient with reaccumulated ascites in whom obstruction of peritoneo-venous shunt was suspected. 5 mCi of $^{99m}Tc-phytate$ was injected into the peritoneal cavity and imaging of the abdomen was performed $1\sim30$ minutes later. With a proper funtioning shunt, radioactivity in the liver and spleen were easily identifiable in this case. If the shunt is obstructed, tracer activity will remain in the peritoneal cavity and thus can not be identifiable in the liver or spleen. Conclusively, radionuclide methods might be very useful for evaluation of peritoneo-venous shunt patency.

• Radioisotope journal
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• v.12 no.2
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• pp.54-56
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• 1997

• Radioisotope journal
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• v.7 no.4
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• pp.18-23
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• 1992