• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.54-62
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• 1996

Background: $^{99m}Tc$ MIBI(Methoxyisobutylisonitrile complex), a member of the isonitrile class of coordination compounds, is a lipophilic cation presently under investigation for clinical use as myocardial perfusion imaging agent and is widely used to detect myocardial infarction. Preliminary reports indicate that $T_1$-201 accumulate in human neoplasm and several authors reported $^{99m}Tc$ MIBI may also localized in primary malignant tumor and metastatic deposits from lung cancer. We evaluated the uptake of $^{99m}Tc$ MIBI in lung cancer and localization of mediastinal and other site metastasis, and compared the benign lesion of the lung. Method: Thirty four patients of lung cancer and ten patients of benign lung lesion were studied with chest CT and $^{99m}Tc$ MIBI Lung SPECT. $^{99m}Tc$ MIBI uptake ratio was assessed by TR/NL(Lung lesion/ Normal area), HT/NL (Heart/Normal area) and HT/TR(Heart/Lung lesion). Results: 1) All lung cancer patients showed increased uptakes of $^{99m}Tc$ MIBI in malignant lung lesion and Tc-99m MIBI uptake was also increased in mediastinal and lymph node metastasis except two cases. 2) There was significant different ratio of TR/NL between malignant and benign lesion, $3.79{\pm}1.82$ and $1.67{\pm}0.63$ on planar images, respectively(p<0.001). 3) There was no significant difference of $^{99m}Tc$ MIBI uptake ratio between squamous cell carcinoma, small cell carcinoma and adeno carcinoma($3.64{\pm}1.66$, $3.57{\pm}0.72$, $4.31{\pm}2.28$ respectively). Conclusion: $^{99m}Tc$ MIBI lung SPECT was useful in the localization of tumor and mediastinal or other site metastatic lesion in lung cancer and also in the differential diagnosis between benign and malignant lesion.

• The Korean Journal of Nuclear Medicine Technology
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• v.25 no.1
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• pp.15-20
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• 2021

Purpose This article studies the relationship between the length of a kidney measured by two scanning methods: Kidney Computed Tomography (CT) and ^99mTc-Dimercaptosuccinic acid (DMSA) renal scan. Kidney CT provides a better anatomic assessment, while ^99mTc-DMSA renal scan is superior in the kidney function test. Materials and Methods From January to December of 2019, two hundred patients who had Kidney CT and Tc^99m-DMSA renal scan were chosen for this study. SPSS17.0 was selected for statistical analysis. Results Due to the effect of the breathing and resolution of ^99mTc-DMSA renal scan, it showed the kidney's relatively longer length than the length of Kidney CT. For the same kidney, the length comparison among different brands' Gamma cameras was negligible. The length difference within the same age group did not show a noticeable discrepancy. However, there was a length difference between the radio technologists. Kidney CT and ^99mTc-DMSA renal scan indicated a strong positive correlation between the length of the left and right kidney. Conclusion It is necessary to establish a standardized measurement method for measuring kidney length using ^99mTc-DMSA renal scan. The kidney's functional changes and length changes are indications of Kidney diseases. Especially, pediatric patients tend to use ^99mTc-DMSA renal scan for assessing the kidney's shape and the function to avoid potential radiation exposure during the Kidney CT. Therefore, it is significant to provide not only the kidney's functional information but also an anatomic analysis, including the kidney's size, length, and location through the ^99mTc-DMSA renal scan.

• Nuclear Engineering and Technology
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• v.51 no.1
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• pp.176-189
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• 2019

This paper presents a feasibility study for producing the medical isotope $^{99m}Tc$ using the hazardous and currently wasted radioisotope $^{99}Tc$. This can be achieved with the nuclear resonance fluorescence (NRF) phenomenon, which has recently been made applicable due to high-intensity laser Compton scattering (LCS) photons. In this work, 21 NRF energy states of $^{99}Tc$ have been identified as potential contributors to the photo-production of $^{99m}Tc$ and their NRF cross-sections are evaluated by using the single particle estimate model and the ENSDF data library. The evaluated cross sections are scaled using known measurement data for improved accuracy. The maximum LCS photon energy is adjusted in a way to cover all the significant excited states that may contribute to $^{99m}Tc$ generation. An energy recovery LINAC system is considered as the LCS photon source and the LCS gamma spectrum is optimized by adjusting the electron energy to maximize $^{99m}Tc$ photo-production. The NRF reaction rate for $^{99m}Tc$ is first optimized without considering the photon attenuations such as photo-atomic interactions and self-shielding due to the NRF resonance itself. The change in energy spectrum and intensity due to the photo-atomic reactions has been quantified using the MCNP6 code and then the NRF self-shielding effect was considered to obtain the spectrums that include all the attenuation factors. Simulations show that when a $^{99}Tc$ target is irradiated at an intensity of the order $10^{17}{\gamma}/s$ for 30 h, 2.01 Ci of $^{99m}Tc$ can be produced.

• The Korean Journal of Nuclear Medicine
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• v.29 no.3
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• pp.313-318
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• 1995

Reflux of bile and digestive enzymes from the small bowel and duodenum into stomach has been observed in patients with various gastroduodenal diseases. Tc-99m iminodiacetic acid delivatives hepatobiliary scan has been used as a noninvasive method to detect duodenogastric reflux. Sometimes, gastric reflux can be observed incidentally on routine Tc-99m DISIDA hepatobiliary scintigraphy. To evaluate the clinical meaning of gastric reflux on routine Tc-99m DISIDA hepatobiliary scan, we analyzed 36 patients showed gastric reflux incidentally on the routine Tc-99m DISIDA hepatobiliary scintigraphy from December 1991 to June 1995 in Chungnam National University Hospital. The results were as follows : 1) The gastric reflux was observed in 2.3% of 1,553 cases of routine Tc-99m DISIDA Hepatobiliary scintigraphy for 43 months. 2) Nineteen percent of patients with gastric reflux had the past medical history of operations on stomach or biliary system. And that history was more prevalent in patients with reflux than those without reflux, significantly (p<0.01). 3) On fiberoptic gastroduodenoscopic examination, 87% of the patients with gastric reflux had the gastroduodenal diseases such as gastritis, gastric ulcer, duodenal ulcer, gastric cancer, duodenal cancer and ampullary diverticulosis. We thought that the gastric reflux can be observed considerably in patients without any operation history on stomach or duodenum, although the operation history is more prevalent in patients with gastric reflux than those without reflux, significantly and most of patients with gastric reflux on routine Tc-99m DISIDA scan has various gastroduodenal diseases.

• The Korean Journal of Nuclear Medicine
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• v.38 no.6
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• pp.506-510
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• 2004

Purpose: We investigated whether Tc-99m MIBI imaging is useful to predict the response of drug treatment in patients with rheumatoid arthritis. Materials and Methods: 24 patients (15 women and 9 men, age $49{\pm}12$ year) rheumatoid arthritis and treated with disease modifying antirheumatic drugs (DMARDs) were included in this study. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) were measured, and Tc-99m MIBI scan was obtained before drug treatment. Quantitative analysis of uptake in diseased joints was performed and expressed as joint-to background ratio (J/B) and percent retention (%R) of Tc-99m MIBI. Clinical symptoms were evaluated and graded from 0 (no) to 3 (severe) regarding to presence of tenderness and swelling. Results: J/B of the diseased joints were significantly correlated with ESR and CRP (p<0.05). A highly significant correlation was found between the improvement of clinical symptoms and %R of Tc-99m MIBI (p<0.05). Conclusion: The results demonstrate that Tc-99m MIBI scan may be used to predict the therapeutic response in patients with rheumatoid arthritis.

• The Korean Journal of Nuclear Medicine
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• v.31 no.3
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• pp.395-398
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• 1997

Whole body $^{99m}Tc-MIBI$ scan in conjunction with parathyroid scan is an effective method in detecting parathyroid lesions in patients with bone pain and possible bone lesions such as brown tumors.

• The Korean Journal of Nuclear Medicine
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• v.28 no.1
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• pp.106-111
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• 1994

2-iminothiolane is known to bind $NH_2$ group of lysine in the protein and deliver SH group, which can be used to label protein with $^{99m}Tc$. In this study, we looked for the best reaction condition in which 2-iminothiolane is conjugated to human polyclonal IgG and labeling condition with $^{99m}Tc$-glucoheptonate. Labeling yield was measured with TSK G4000SW column and HPLC or precipitation with 10% TCA (trichloroacetic acid) and 1% HSA. In vivo distribution was investigated with Staphylococcal abscess bearing rats. With decreasing glucoheptonate, the labeling yield decreased. Without 2-iminothiolane, $^{99m}Tc$-glucoheptonate was bound to IgG, which seemed to be direct labeling. With increasing 2-iminothiolane upto 20 times higher than IgG, the labeling yield increased, and plateau was seen with higher molar excess of 2-iminothiolane. Polymer formation was not observed. The pH for the conjugation of 2-iminothiolane and IgG was best around 6.4. $^{99m}Tc$-2-iminothiolane-IgG showed faster blood clearance, higher renal activity and lower hepatic and splenic activity than $^{99m}Tc$-DTPA-IgG. The biodistribution of $^{99m}Tc$-2-iminothiolane-IgG with higher molar excess of 2-iminothiolane was not different from that with lower molar excess. Labeling antibodies with $^{99m}Tc$ using 2-iminothiolane can afford a possible route to simple labeling and wide clinical use of the immunoscintigraphy.

• The Korean Journal of Nuclear Medicine Technology
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• v.28 no.1
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• pp.1-11
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• 2024

Hypoxia, defined as the deficiency of oxygen, is a significant hallmark of cancers presenting in the majority of solid tumors. Detection of tumor hypoxia is essential in cancer diagnosis to prevent cancer progression, metastasis, and resistance to cancer therapies in clinical practices. Single-photon emission computed tomography (SPECT) is one of the methods studied and applied for hypoxia detection with the use of radiolabeled imaging agents in which ^99mTc is the common radioisotope used for radiolabeling. Nitroimidazoles are the hypoxia-targeting moieties presenting in numerous ^99mTc-radiolabeled imaging agents due to their bio-reducible ability in hypoxic environments. Recently, in addition to ^99mTc-labeled radiopharmaceuticals containing one nitroimidazole unit, there has been considerable attention given to ^99mTc-radiopharmaceuticals bearing two or more nitroimidazole units. This review summarizes the synthesis of hypoxia-targeting chelators and radiolabeling processes to produce these ^99mTc-radiopharmaceuticals for SPECT imaging.

• The Korean Journal of Nuclear Medicine
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• v.36 no.4
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• pp.244-254
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• 2002

Purpose: This study investigated the differences between technetium-99m ethyl cysteinate dimer (Tc-99m ECD) and technetium-99m hexamethylpropylene amine oxime (Tc-99m HMPAO) uptake in the normal brain by means of statistical parametric mapping (SPM) analysis. Materials and Methods: We retrospectively analyzed age and sex matched 53 cases of normal brain SPECT. Thirty-two cases were obtained with Tc-99m ECD and 21 cases with Tc-99m HMPAO. There were no abnormal findings on brain MRIs. All of the SPECT images were spatially transformed to standard space, smoothed and globally normalized. The differences between the Tc-99m ECD and Tc-99m HMPAO SPECT images were statistically analyzed using statistical parametric mapping (SPM'99) software. The differences bgetween the two groups were considered significant ant a threshold of corrected P values less than 0.05. Results: SPM analysis revealed significantly different uptakes of Tc-99m ECD and Tc-99m HMPAO in the normal brains. On the Tc-99m ECD SPECT images, relatively higher uptake was observed in the frontal, parietal and occipital lobes, in the basal ganglia and thalamus, and in the superior region of the cerebellum. On the Tc-99m HMPAO SPECT images, relatively higher uptakes was observed in subcortical areas of the frontal region, temporal lobe, and posterior portion of inferior cerebellum. Conclusion: Uptake of Tc-99m ECD and Tc-99m HMPO in the normallooking brain was significantly different on SPM analysis. The selective use of Tc-99m ECD of Tc-99m HMPAO in brain SPECT imaging appears especially valuable for the interpretation of cerebral perfusion. Further investigation is necessary to determine which tracer is more accurate for diagnosing different clinical conditions.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.5
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• pp.354-361
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• 2008

Purpose: N-13 ammonia uptake and retention in the myocardium is related to perfusion and metabolism. There are several potential advantages of N-13 ammonia positron emission tomography (PET) to detect myocardial ischemia, such as higher spatial resolution, greater counting efficiencies, and robust attenuation correction. But there are few reports comparing Tc-99m myocardial perfusion single photon emission tomography (MPS) and N-13 ammonia PET. We thus compared adenosine stress N-13 ammonia PET/CT and Tc-99m sestamibi MPS in patients with suspected coronary artery stenosis. Materials and Methods: Seventeen patients (male 13 : $63{\pm}11$ years old) underwent adenosine stress N-13 ammonia PET/CT (Discovery ST, GE), Tc-99m sestamibi MPS (dual head gamma camera, Hawkeye, GE) and coronary angiography within 1 week. N-13 ammonia PET/CT and Tc-99m sestamibi MPS images were assessed with a 20-segment model by visual interpretation and quantitative analysis using automatic quantitative software (Myovation, GE). Results: Both sensitivities and specificities of detecting an individual coronary artery stenosis were higher for N-13 ammonia PET/CT than Tc-99m sestamibi MPS (PET/CT: 91%/89% vs MPS: 65%/82%). N-13 ammonia PET/CT showed reversibility in 52% of segments that were considered non-reversibile by Tc-99m sestamibi MPS. In the 110 myocardial segments supplied by the stenotic coronary artery, N-13 ammonia PET/CT showed higher count densities than Tc-99m MPS on rest study (p < 0.01), and the difference of count density between the stress and the rest studies was also larger on N-13 ammonia PET/CT. Conclusion: Adenosine stress N-13 ammonia PET/CT had higher diagnostic sensitivity and specificity, more reversibility of perfusion defects and greater stress/rest uptake differences than Tc-99m sestamibi MPS. Accordingly, N-13 ammonia PET/CT might offer better assessment of myocardial ischemia and viability.