• Journal of Acupuncture Research
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• v.17 no.2
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• pp.247-259
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• 2000

Objective : The mechanism of acupuncture to increase cerebral blood flow is still uncertain. The purpose of this study was to evaluate the neural basis of acupuncture by comparing the cerebral regions activated by the stimulation of two different methods of acupunctures at the same acupoint which was suggested by oriental medicine to increase rCBF. Materials and Methods : Thirty-nine healthy volunteers(26 males, 13 females, age $31{\pm}11$ years) were studies by rest/acupuncture Tc-99m ECD brain SPECT using a subtraction method. SPECTs using two methods(needle retention and heated needle with 90% alcohol) at two acupoints (right LI. 4 and ST. 36) were peformed at an interval of three days. For the needle retention method, acupuncture needle was inserted to a depth of about 2 cm into each acupoint 8 minutes after the lst acquisition and continued to retain, and the second injection of Tc-99m ECD was done 15 minutes after the insertion of needle. For the heated acupuncture method, heated needle was inserted in a twinkle within several msec 20 second after the second injection of Tc-99m ECD. The differences of between rest and acupuncture activation state were statistically analyzed using a statistical parametric mapping software. Result : Acupunctures of both methods reveal similar patterns of increase in rCBF. Acupuncture at ST.36 increase rGBF in left anterior temporal, right inferior frontal lobes, and left cerebellum. Acupuncture at LI. 4 increase rCBF in the left frontal cortex, right temporal pole, both inferior frontal cortices and right cerebellum. Conclusion : The effects of two different acupunctures to the same acupoints on rCBF were similar. Therefore, this result suggests Chat the mechanism of acupuncture in the increase of cerebral blood flow have a neural basis.

• The Korean Journal of Nuclear Medicine
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• v.34 no.5
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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.

• Journal of Korea Water Resources Association
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• v.32 no.2
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• pp.177-184
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• 1999

In this paper, the characteristics of the flow and the movement of the floc were analyzed through the experiments in the sedimentation basin using the redioisotope. Tc-99m radioisotope was used for the experiments for the characteristics of the flow, and the bentonite absorbing Tc-99m radioisotope was used in the experiments for the movement of the floc. Through the experiments of the flow, it was found that the velocities of flow in the sedimentation basin were different depending upon the position and the depth. The distance of the moving trajectories of the floc is increased by increasing the discharge. By increasing the discharge, the settling point is farther from the inlet, and the turbidity removal efficiencies in the sedimentation basin are decreased. The moving velocities of the floc and the density are changed in the different depths in the sedimentation basin.

• The Korean Journal of Nuclear Medicine
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• v.21 no.2
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• pp.191-197
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• 1987

39 patients with focal hepatic lesions were evaluated by $^{99m}Tc-RBC$ liver scan. The diagnosis of focal hepatic lesions were made by percutaneous needle biopsy, angiography, surgery, or clinical courses. Thses diagnoses included 24 cases of hemangioma, 7 hepatomas, 6 metastatic disease, 1 abscess, and 1 cyst. 19 hemangiomas showed focal hot activity on delayed static planar images. 3 small deep seated hemangiomas were diagnosed by SPECT that would have been missed by planar images alone. 2 large hemangiomas had no radioisotope uptake within the lesions on delayed images and at surgery cavernous hemangioma with thrombosis, calcification, and fibrosis were found. For hepatic hemangiomas in our series, the sensitivity was 91.7% and the specificity was 100%. The remaining 15 patients including hepatomas, metastatic lesions, cyst and abscess showed cold defect on delayed blood pool images. It is concluded that $^{99m}Tc-RBC$ liver scan should be the choice of primary diagnostic procecure for clinically suspected hepatic hemangioma since it's inexpensive, non-invasive, and readly available.

• The Korean Journal of Nuclear Medicine
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• v.34 no.4
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• pp.360-365
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• 2000

We experienced a case of cerebral hypoperfusion due to cyclosporine neurotoxocity confirmed only by Tc-99m ECD brain SPECT. A 53-year-old female had received allogenic peripheral blood stem cell transplantation due to refractory plasmacytoid lymphoma. Cyclosporine and steroid had been administrated to prevent graft versus host disease. Twenty days after transplantation, she became delirious and suffered from generalized tonic-clonic seizure. Immediately, brain MRI and MR angiography were performed and these studies did not show any abnormal findings. However, Tc-99m ECD brain SPECT showed diffuse hypoperfusion in the left cerebral hemisphere and blood cyclosporine level was 962.6 ng/ml. Cyclosporine administration was stopped and discontinuation of cyclosporine resulted in disappearance of all neurological symptoms. The same neurological symptoms recurred with cyclosporine re-administration for management of exacerbated graft versus host disease. In this case, Tc-99m ECD brain SPECT proved very helpful in the diagnosis of cycloporine neurotoxicity.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.6 no.2
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• pp.75-91
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• 2020

[^99mTc]Tc-Hexamethylpropylene amine oxime (HMPAO) is currently used as a regional cerebral blood flow imaging agent for single photon emission computed tomography (SPECT). The HMPAO ligand exists in two isomeric forms: d,l and meso showing different properties in vivo. Later studies indicated that brain uptake patterns of ^99mTc-complexes formed from separated enantiomers differed. Separation of enantiomers is difficult by fractional crystallizations method. Usually, the substance is obtained in low chemical yield in a time-consuming procedure. Furthermore, the final product still contains some impurity. So we have developed new efficient route for synthesis of R,R- and S,S-HMPAO enantiomeric compounds in 6-steps. Nucleophilic substitution (S_N2) reactions of 2,2-dimethylpropane-1,3-diamine either with S- (1a) or R-methyl2-chloropropanoate (1b) were performed to produce compounds R,R- (2a) or S,S-isomer (2b) derivatives protected with benzylchloroformate (Cbz), respectively. And then Weinreb amide and methylation reaction using Grignard reagent, oxime formation with ketone group and deprotectiion of Cbz group by hydrogenolysis gave S,S- (7a) or R,R-HMPAO (7b), respectively. Entaniomeric compounds were synthesied with high yield and purity without any undesired product. The 7a or 7b kits containing 10 ㎍ SnCl₂-2H₂O were labeled with ^99mTc with high radiolabeling yield (90%).

• The Korean Journal of Nuclear Medicine Technology
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• v.28 no.1
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• pp.23-29
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• 2024

Purpose: 99mTc-mebrofenin hepatobiliary scintigraphy (HBS) is an important and clinically useful diagnostic imaging study for detecting complications after liver transplantation. CT contrast agents due to their high atomic numbers, lead to a decrease in gamma ray count rates. This study investigated the impact of CT contrast agents on the uptake of 99mTc-mebrofenin in the liver. Materials and Methods: The quantitative HBS was performed on sixty-two liver transplantation patients (male:female=36:26), with a mean age of 59.4±6.4 years. Statistical comparison of hepatic uptake reduction ratio (HURR%) before and after the injection of CT contrast agents was performed using a paired t-test. Results: Hepatic uptake of the reduction ratio was 94.47±3.65% for the pre-CT contrast agents and 92.17±4.00% for the post-CT contrast agents. HURR% after CT contrast agent injection showed a statistically significant difference compared to before the injection (t=11.09, P<0.001). Conclusion: It will be necessary to pay attention when examining the HBS of patients with liver transplantation after the injection of CT contrast medium. It is advisable to schedule the examination on a different day to prevent residual contrast medium in the body from interfering with the quantitative evaluation of the nuclear medicine examination.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.67-72
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• 2010

Purpose: In Asan Medical Center we perform myocardial perfusion SPECT to evaluate cardiac event risk level for non-cardiac surgery patients. In case of patients with cancer, we check tumor metastasis using whole body bone scan and whole body PET scan and then perform myocardial perfusion SPECT to reduce unnecessary exam. In case of short term in patients, we perform $^{201}Tl$ myocardial perfusion SPECT after whole body bone scan a minimum 16 hours in order to reduce hospitalization period but it is still the actual condition in which the evaluation about the affect of the crosstalk contamination due to the each other dissimilar isotope administration doesn't properly realize. So in our experiments, we try to evaluate crosstalk contamination influence on $^{201}Tl$ myocardial perfusion SPECT using anthropomorphic torso phantom and patient's data. Materials and Methods: From 2009 August to September, we analyzed 87 patients with $^{201}Tl$ myocardial perfusion SPECT. According to $^{201}Tl$ myocardial perfusion SPECT yesterday whole body bone scan possibility of carrying out, a patient was classified. The image data are obtained by using the dual energy window in $^{201}Tl$ myocardial perfusion SPECT. We analyzed $^{201}Tl$ and $^{99m}Tc$ counts ratio in each patients groups obtained image data. We utilized anthropomorphic torso phantom in our experiment and administrated $^{201}Tl$ 14.8 MBq (0.4 mCi) at myocardium and $^{99m}Tc$ 44.4 MBq (1.2 mCi) at extracardiac region. We obtained image by $^{201}Tl$ myocardial perfusion SPECT without gate method application and analyzed spatial resolution using Xeleris ver 2.0551. Results: In case of $^{201}Tl$ window and the counts rate comparison result yesterday whole body bone scan of being counted in $^{99m}Tc$ window, the difference in which a rate to 24 hours exponential-functionally notes in 1:0.114 with Ventri (GE Healthcare, Wisconsin, USA), 1:0.249 after the bone tracer injection in 12 hours in 1:0.411 with 1:0.79 with Infinia (GE healthcare, Wisconsin, USA) according to a reduction a time-out was shown (Ventri p=0.001, Infinia p=0.001). Moreover, the rate of the case in which it doesn't perform the whole body bone scan showed up as the average 1:$0.067{\pm}0.6$ of Ventri, and 1:$0.063{\pm}0.7$ of Infinia. According to the phantom after experiment spatial resolution measurement result, and an addition or no and time-out of $^{99m}Tc$ administrated, it doesn't note any change of FWHM (p=0.134). Conclusion: Through the experiments using anthropomorphic torso phantom and patients data, we found that $^{201}Tl$ myocardium perfusion SPECT image later carried out after the bone tracer injection with 16 hours this confirmed that it doesn't receive notable influence in spatial resolution by $^{99m}Tc$. But this investigation is only aimed to image quality, so it needs more investigation in patient's radiation dose and exam accuracy and precision. The exact guideline presentation about the exam interval should be made of the validation test which is exact and in which it is standardized about the affect of the crosstalk contamination according to the isotope use in which it is different later on.

• 대한핵의학회:학술대회논문집
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• 2000.05a
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• pp.77.2-77.2
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• 2000

• The Korean Journal of Nuclear Medicine
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• v.37 no.4
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• pp.254-259
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• 2003

$^{99m}Tc-galactosyl$ human serum albumin (Tc-GSA) is a radiopharmaceutical that binds to asialoglycoprotein receptors, which are specifically present in the hepatocyte membrane. Because these receptors are decreased in hepatic parenchymal damage, the degree of Tc-GSA accumulation in the liver correlates with findings of liver function test. Hepatic images were performed with Tc-GSA in patients with acute hepatic dysfunction by Amantia Subjunquillea poisoning, and compared with these of liver ultrasonography (USG). Tc-GSA (185 MBq, 3 mg of GSA) was injected intravenously, and dynamic images were recorded for 30 minutes. Time-activity curves for the heart and liver were generated from regions of interest for the whole liver and precordium. Degree of hepatic uptake and clearance rate of Tc-GSA were generated by visual interpretation and semiquantitative analysis parameters (receptor index : LHL15 and index of blood clearance : HH15). Visual assessment of GSA scintigraphy revealed mildly decreased liver uptake in all of subjects. The mean LHL15 and HH15 were 0.886 and 0.621, graded as mild dysfunction in 2, and mild to moderate dysfunction in 1 subject. In contrast, liver USG showed no remarkable changes of hepatic parenchyme. Tc-GSA scintigraphy was considered as a useful imaging modality in the assessment of the hepatic dysfunction.