• Title, Summary, Keyword: 방사선 치료

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The Clinical Characteristics of Diffuse Alveolar Hemorrhage : A Retrospective Study of 21cases (미만성 폐포 출혈의 임상 양상과 예후)

  • Ham, Hyoung-Suk;Roh, Gil-Hwan;Kang, Eun-Hae;Kang, Soo-Jung;An, Chang-Hyeok;Suh, Gee-Young;Chung, Man-Pyo;Kim, Ho-Joong;Kwon, O-Jung;Rhee, Chong-H.
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.5
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    • pp.614-623
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    • 2000
  • Background : Diffuse alveolar hemorrhage (DAH) is rare but often fatal. To determine the clinical manifestations of DAH, its etiology, clinical course and prognosis were studied. Method : A retrospective analysis was performed in 21 patients that were diagnosed as DAH. Diagnosis of DAH was based on the presence of the "classical triad" of hemoptysis, anemia, and rapidly progressive infiltrates on chest X-ray and a finding of bronchoalveolar lavage or lung biopsy. Results : Thirteen patients (61.9%) had collagen vascular diseases (CVDs) as underlying disease and 10 patients had systemic lupus erythematosus. Females were more prevalent in CVD than in non-collagen vascular disease (NCVD). Otherwise, there were no significant differences between the two groups in terms of clinical manifestations. Dyspnea (95.2%), cough (76.2%), hemoptysis (61.9%), and fever (33.0%) were frequent symptoms. The initial creatinine level was higher in CVD than in NCVD ($3.27{\pm}3.15$ mg/dl vs. $1.19{\pm}0.94$ mg/dl, p=0.030). The corresponding drop in hemoglobin level was $2.69{\pm}1.26$ g/dl. Maximal drop in hemoglobin preceded the progression of infiltrates on the chest radiograph by $1.38{\pm}4.22$ days. The mortality rate was higher in the patients with NCVD than in those with CVD (50.0% vs. 23.1%). Conclusion : The DAH can occur not only in patients with CVD but also in those with NCVD. Higher creatinine level CVD in patients is associated with renal involvement in conjunction with DAH. The maximal drop in hemoglobin preceeding the progression of infiltrates on the chest radiograph suggests that the drop in hemoglobin is important for diagnosing DAH.

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Validity of Clinically Used Tray Transmission Factor (임상적으로 쓰이는 차폐선반투과율의 타당성에 관한 연구)

  • 윤형근
    • Progress in Medical Physics
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    • v.14 no.4
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    • pp.218-224
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    • 2003
  • Purpose:By evaluating the dependence of the tray transmission factor (tray factor) on collimator setting and tray thickness, we determined the validity of the clinically used single tray factor for standard radiation field size (10${\times}$10 $\textrm{cm}^2$). Methods and Materials:For each X ray energies (6 and 10 MV), outputs were measured by using 5 steps of tray thickness (0, 6, 8, 10, 12 mm) and 7 steps of radiation field size (5${\times}$5, 10${\times}$10, 15${\times}$15, 20${\times}$20, 25${\times}$25, 30${\times}$30, 35${\times}$35 $\textrm{cm}^2$) at 10 cm phantom depth. Outputs were measured in both 'with tray' and 'without tray' conditions by using radiation with the same monitor units, and the tray factors were determined by the ratios of the two outputs. To evaluate the validity of a single tray factor obtained for standard radiation field, we analyzed the pattern of the field sizes in cases treated at our hospital in 2002. Results : In the 6 MV X-ray, the increases in the tray factor between the standard field (l0${\times}$10 $\textrm{cm}^2$) and the largest field (35${\times}$35 $\textrm{cm}^2$) were 0.517%, 0.835%, 1.058%, 1.066% in 6, 8, 10, and 12 mm thickness tray, respectively. In the 10 MV X-ray, the increases in the fray factor between the standard field (10${\times}$10 $\textrm{cm}^2$) and the largest field (35${\times}$35 $\textrm{cm}^2$) were 0.517%, 0.836%, 1.058%, 1.066% in 6, 8, 10, 12 mm thickness tray, respectively. In a major portion of clinical cases, when the field size was smaller than 20${\times}$20 $\textrm{cm}^2$, the tray factor was in good agreement with the standard tray factor. However, in cases where the field sizes were 30${\times}$30 $\textrm{cm}^2$ and 35${\times}$35 $\textrm{cm}^2$, the error could exceed 1.0%. Conclusion:The tray factor increased with increasing field size or decreasing tray thickness. The difference of tray factor between the small field and the large field increased with increasing tray thickness. Furthermore, the standard tray factor was valid in most clinical cases except for when the field size was greater than 30${\times}$30 $\textrm{cm}^2$, wherein the error could exceed 1.0%.

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Diagnostic Values of Abdominal Ultrasonography in Patients with Fever and Abdominal Symptoms (발열과 복부 증상을 주소로 하는 환아에서 복부 초음파 검사의 진단적 의의에 관한 연구)

  • Lee, Mi-Kyung;Im, Chang-Sung;Ahn, Sun-Mi;Kim, Chang-Hi;Lee, Dong-Jin;Kwan, Joong-Hyuck;Park, Yong-Hoon
    • Yeungnam University Journal of Medicine
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    • v.12 no.2
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    • pp.191-202
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    • 1995
  • Purpose: Acute febrile illness in children frequently accompanies with abdominal symptoms such as vomiting, diarrhea, and abdominal pain, even if its etiology is not occured from the gastrointestinal tract. If the etiology of fever was unknown and the fever was accompanied with abdominal symptoms, we should be concerned about whether the etiology of fever was originated from the gastrointestinal tract or interpretated from the abnormality in the gastrointestinal tract. This study was performed to evaluate the diagnostic value of abdominal ultrasonography in patients with fever and abdominal symptoms. Methods: We reviewed retrospectively the medical records of abdominal ultrasonographic (US) findings of 60 cases of acute febrile illness with abdominal symptoms at department of Pediatrics, Ulsan Dongang General Hospital during the period from January 1994 to June 1995. Results: The abnormal abdominal US findings obtained were as follows. 1) The abnormal US findings were seen in 56 cases (93.3%). 2) The most common abnormal US finding was the enlarged mesenteric lymph nodes in 52 cases (86.7%) 3) The enlarged mesenteric lymph nodes with or without intra-abdominal fluid were seen in 30 cases (50.0%) of a wide variety of illnesses, so their diagnostic values were absent. 4) The enlarged mesenteric lymph nodes and splenomegaly with or without ileocecitis were seen in 7 cases. Among them, 4 cases (6.7%) were confirmed as typhoid fever. 5) The US findings in 6 cases of typhoid fever were the enlarged mesenteric lymph nodes in all cases (100%), splenomegaly in 4 cases (66.7%), ileocecitis in 1 case (16.7%), enlarged mesenteric lymph nodes and splenomegaly in 4 cases (66.7%), enlarged mesenteric lymph nodes, splenomegaly and ileocecitis in 1 cases (16.7%). 6) The enlarged mesenteric lymph nodes and the abnormalities around the appendix were seen in 7 cases (11.7%), which were confirmed as appendicitis all. 7) The thickening of wall in urinary bladder was seen in 2 cases (3.3%) of acute cystitis and acute hemorrhagic cystitis. 8) The subtle thickening of wall in colon was seen in 1 cases (1.7%) of shigellosis. Conclusions: The enlarged mesenteric lymph nodes, splenomegaly and ileocolitis on the abdominal ultrasonography in patients with fever and abdominal symptoms aree suggestive findings of typhoid fever. The enlarged mesenteric lymph nodes and the abnormalities around the appendix on abdominal ultrasonography make the rapid diagnosis of acute appendicitis and its complications, when physical examination is difficult in small children and diagnosis of their illnesses is obscure in patients with fever and abdominal pain.

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Survival Value of Myocutaneous Flaps in the Management of Epidermoid Carcioma of the Oral Cavity (구강내 상피암의 치료에서 근피부판이 생존율에 미치는 영향)

  • Seel David John;Park Chul-Young;Yoo Chung-Joon;Lee Samuel;Park Yoon-Kyu
    • Korean Journal of Head & Neck Oncology
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    • v.6 no.2
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    • pp.79-84
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    • 1990
  • This paper is a review of our experience with radical resection for cancer of the oral cavity with particular emphasis upon the value of myocutaneous(i.e., musculocutanous) flaps employed in the surgical reconstruction in patient survival. During the past 15 years, 98 patients underwent resection of cancer arising in the oral cavity and oropharynx. Of these, 14 had composite resections in which the mandible was not sectioned, and 4 underwent en bloc resections without neck dissections in the face of post-radiation recurrence. When these excluded, 84 patients who underwent COMMANDO procedures with or without myocutaneous flaps were suitable for analysis of recurrence and survival according to the various surgical technics employed. 1) According to the surgical technic, there were 24 standard COMMANDO procedures in whom no regional or myocutanous flap was used; 12 patients who underwent reconstruction employing a forehead flap; 19 patients in whom a posterior cervical 'nape' flap was employed; 27 patients who underwent myocutaneous or osteo-myocutaneous flap repair; and two patients who had double flap repair. 2) The uncorrected two-year disease free survival was 41% for standard COMMANDOs, 17% for forehead flap COMMANDOs; 35% for nape flap COMMANDOs; and 35% for myocutaneous flap COMMANDO procedures. 3) The two-year disease-free survival by Stage was 100% in Stage I, 45% in Stage II, 41% in Stage III, and 18% in Stage IV. 4) When myocutanous flaps cases were compared with Group I, comprised of matched historical controls including both Standard COMMANDOs and those who had undergone regional flap repairs(that is, forehead and nape flap COMMANDOs)there was no difference, both groups showing a 40% 2-year disease-free survival. 5) When musculocutanous flap cases were compared with Goup II, which was composed of matched historical controis limited to patients who had undergone regional flap repairs(that is, forehead and nape flap cases only)there was no difference, both groups showing a 27% 2-year desease-free survival. 6) When musculocutanous flap cases were compared with Group III, composed of patients who had undergone classic COMMANDO procedures without any sort of flap repair, there was a striking difference; the patients undergoing MC flap repair showed 50% 2-year disease-free survival, whereas the classic COMMANDO cases showed a 25% survival free of disease. 7) Locoregional recurrence was also evaluated in the four categories; for standard COMMANDO cases it was 25%, for nape flap cases 26% ; for forehead flap cases, 33%, and for the musculocutaneous flap cases, the lowest recurrence rate, 22%. These results are of particular significance in view of the fact that the proportion of advanced cases(Stage III and IV)in each category was 67% of standard cases, 79% of nape flap patients, 100% of forehead flap cases, and 96% of musculocutaneous flap cases.

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The Clinical Features of Endobronchial Tuberculosis - A Retrospective Study on 201 Patients for 6 years (기관지결핵의 임상상-201예에 대한 후향적 고찰)

  • Lee, Jae Young;Kim, Chung Mi;Moon, Doo Seop;Lee, Chang Wha;Lee, Kyung Sang;Yang, Suck Chul;Yoon, Ho Joo;Shin, Dong Ho;Park, Sung Soo;Lee, Jung Hee
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.5
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    • pp.671-682
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    • 1996
  • Background : Endobronchial tuberculosis is definded as tuberculous infection of the tracheobronchial tree with microbiological and histopathological evidence. Endobronchial tuberculosis has clinical significance due to its sequela of cicatrical stenosis which causes atelectasis, dyspnea and secondary pneumonia and may mimic bronchial asthma and pulmanary malignancy. Method : The authors carried out, retrospectively, a clinical study on 201 patients confirmed with endobronchial tuberculosis who visited the Department of Pulmonary Medicine at Hangyang University Hospital from January 1990 10 April 1996. The following results were obtained. Results: 1) Total 201 parients(l9.5%) were confirmed as endobronchial tuberculosis among 1031 patients who had been undergone flexible bronchofiberscopic examination. The number of male patients were 55 and that of female patients were 146. and the male to female ratio was 1 : 2.7. 2) The age distribution were as follows: there were 61(30.3%) cases in the third decade, 40 cases(19.9%) in the fourth decade, 27 cases(13.4%) in the sixth decade, 21 cases(10.4%) in the fifth decade, 19 cases(9.5%) in the age group between 15 and 19 years, 19 cases(9.5%) in the seventh decade, and 14 cases(7.0%) over 70 years, in decreasing order. 3) The most common symptom, in 192 cases, was cough 74.5%, followed by sputum 55.2%, dyspnea 28.6%, chest discomfort 19.8%, fever 17.2%, hemoptysis 11.5%, in decreasing order, and localized wheezing was heard in 15.6%. 4) In chest X-ray of 189 cases, consolidation was the most frequent finding in 67.7%, followed by collapse 43.9%. cavitary lesion 11.6%, pleural effusion 7.4%, in decreasing order, and there was no abnormal findings in 3.2%. 5) In the 76 pulmanary function tests, a normal pattern was found in 44.7%, restrictive pattern in 39.5 %, obstructive pattern in 11.8%, and combined pattern in 3.9%. 6) Among total 201 patients, bronchoscopy showed caseous pseudomembrane in 70 cases(34.8%), mucosal erythema and edema in 54 cases(26.9%), hyperplastic lesion in 52 cases(25.9%), fibrous s.enosis in 22 cases(10.9%), and erosion or ulcer in 3 cases(1.5%). 7) In total 201 cases, bronchial washing AFB stain was positive in 103 cases(51.2%), bronchial washing culture for tuberculous bacilli in 55 cases(27.4%). In the 99 bronchoscopic biopsies, AFB slain positive in 36.4%. granuloma without AFB stain positive in 13.1%, chronic inflammation only in 36.4%. and non diagnostic biopsy finding in 14.1%. Conclusions : Young female patients, whose cough resistant to genenal antitussive agents, should be evaluated for endobronchial tuberculosis, even with clear chest roentgenogram and negative sputum AFB stain. Furthermore, we would like to emphasize that the bronchoscopic approach is a substantially useful means of making a differential diagnosis of atelectasis in older patients of cancer age. At this time we have to make a standard endoscopic classification of endobronchial tuberculosis, and well designed prospective studies are required to elucidate the effect of combination therapy using antituberculous chemotherapy with steroids on bronchial stenosis in patients with endobronchial tuberculosis.

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Usefulness Evaluation of Artifacts by Bone Cement of Percutaneous Vertebroplasty Performed Patients and CT Correction Method in Spine SPECT/CT Examinations (척추 뼈 SPECT/CT검사에서 경피적 척추성형술 시행 환자의 골 시멘트로 인한 인공물과 CT보정방법의 유용성 평가)

  • Kim, Ji-Hyeon;Park, Hoon-Hee;Lee, Juyoung;Nam-Kung, Sik;Son, Hyeon-Soo;Park, Sang-Ryoon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.49-61
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    • 2014
  • Purpose: With the aging of the population, the attack rate of osteoporotic vertebral compression fracture is in the increasing trend, and percutaneous vertebroplasty (PVP) is the most commonly performed standardized treatment. Although there is a research report of the excellence of usefulness of the SPECT/CT examination in terns of the exact diagnosis before and after the procedure, the bone cement material used in the procedure influences the image quality by forming an artifact in the CT image. Therefore, the objective of the research lies on evaluating the effect the bone cement gives to a SPECT/CT image. Materials and Methods: The images were acquired by inserting a model cement to each cylinder, after setting the background (3.6 kBq/mL), hot cylinder (29.6 kBq/mL) and cold cylinder (water) to the NEMA-1994 phantom. It was reconstructed with Astonish (Iterative: 4 Subset: 16), and non attenuation correction (NAC), attenuation correction (AC+SC-) and attenuation and scatter correction (AC+SC+) were used for the CT correction method. The mean count by each correction method and the count change ratio by the existence of the cement material were compared and the contrast recovery coefficient (CRC) was obtained. Additionally, the bone/soft tissue ratio (B/S ratio) was obtained after measuring the mean count of the 4 places including the soft tissue(spine erector muscle) after dividing the vertebral body into fracture region, normal region and cement by selecting the 20 patients those have performed PVP from the 107 patients diagnosed of compression fracture. Results: The mean count by the existence of a cement material showed the rate of increase of 12.4%, 6.5%, 1.5% at the hot cylinder of the phantom by NAC, AC+SC- and AC+SC+ when cement existed, 75.2%, 85.4%, 102.9% at the cold cylinder, 13.6%, 18.2%, 9.1% at the background, 33.1%, 41.4%, 63.5% at the fracture region of the clinical image, 53.1%, 61.6%, 67.7% at the normal region and 10.0%, 4.7%, 3.6% at the soft tissue. Meanwhile, a relative count reduction could be verified at the cement adjacent part at the inside of the cylinder, and the phantom image on the lesion and the count increase ratio of the clinical image showed a contrary phase. CRC implying the contrast ratio and B/S ratio was improved in the order of NAC, AC+SC-, AC+SC+, and was constant without a big change in the cold cylinder of the phantom. AC+SC- for the quantitative count, and AC+SC+ for the contrast ratio was analyzed to be the highest. Conclusion: It is considered to be useful in a clinical diagnosis if the application of AC+SC+ that improves the contrast ratio is combined, as it increases the noise count of the soft tissue and the scatter region as well along with the effect of the bone cement in contrast to the fact that the use of AC+SC- in the spine SPECT/CT examination of a PVP performed patient drastically increases the image count and enables a high density of image of the lesion(fracture).

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Clinical Characteristics of Patients with Taste Disorders (미각 장애 환자의 임상적 특성에 관한 연구)

  • Lee, Eun-Jin;Park, Won-Kyu;Nam, Jin-Woo;Yun, Jong-Il;Kho, Hong-Seop
    • Journal of Oral Medicine and Pain
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    • v.34 no.4
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    • pp.341-351
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    • 2009
  • There is tremendous variability in the ways patients present with taste problems. Because of complex and multifactorial etiological background, it is not simple to evaluate patients with taste disorders. Accurate assessment of patients' status by prudent, thorough history taking and symptom analysis is the most essential for exact diagnosis of taste disorders. The aim of this study was to investigate the clinical characteristics of patients with taste problems as a primary complaint. Consecutive series of 50 patients (12 males and 38 females, mean age $53.6\;{\pm}\;14.7$ years) were included for the present study. All subjects were requested to complete a comprehensive questionnaire. Clinical evaluation procedures included oral examination, interview, questionnaire analysis, panoramic radiography, blood test and measurement of salivary flow rate. The obtained results were as follows: 1. Among the patients, 36 patients (72%) complained of oral mucosal pain or burning sensation. Of these patients, 18 patients (36%) were diagnosed as burning mouth syndrome. 2. Nineteen patients (38%) complained of subjective oral dryness. The flow rate of unstimulated whole saliva was less than 0.1 mL/min in 14 patients (28%) and 17 (34%) had a stimulated whole salivary flow rate of less than 0.5 mL/min. 3. Among the types of taste disorders, hypogeusia, the most frequently reported, was found in 25 patients (50%), dysgeusia in 18 patients (36%), phantogeusia in 15 patients (30%), hypergeusia in 10 patients (20%), and ageusia in 5 patients (10%). Nineteen patients (38%) reported more than one type of taste disorder and the most frequent combination was dysgeusia + hypogeusia (n=6, 12%). 4. Based on data from the medical and dental histories and examinations, the patients were assigned to 12 probable causal categories. Taste disorders due to oral mucosal diseases and idiopathic taste disorder were the most frequent (n=9; 18%, each), followed by psychogenic taste disorder (n=8; 16%), drug-induced taste disorder (n=7; 14%), and taste disorder due to dry mouth (n=6; 12%). These 5 categories of taste disorder accounted for 78% of all cases in this study.

The Findings of Pulmonary Function Test in Patients with Inhalation Injury (흡입화상 환자에서의 폐기능검사 소견)

  • Kim, Jong Yeop;Kim, Cheol Hong;Shin, Hyun Won;Chae, Young Je;Choi, Chul Young;Shin, Tae Rim;Park, Yong Bum;Lee, Jae Young;Bahn, Joon-Woo;Park, Sang Myeon;Kim, Dong-Gyu;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.653-662
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    • 2006
  • Background: The changes in the pulmonary function observed in burn patients with an inhalation injury are probably the result of a combination of airway inflammation, chest wall and muscular abnormalities, and scar formation. In addition, it appears that prolonged ventilatory support and an episode of pneumonia contribute to the findings. This study investigated the changes in the pulmonary function in patients with inhalation injury at the early and late post-burn periods. Methods: From August 1, 2002, to August 30, 2005, surviving burn patients who had an inhalation injury were enrolled prospectively. An inhalation injury was identified by bronchoscopy within 48hours after admission. Spirometry was performed at the early phase during admission and the recovery phase after discharge, and the changes in the pulmonary function were compared. Results: 37 patients (M=28, F=9) with a total burn surface area (% TBSA), ranging from 0 to 18%, were included. The initial $PaO_2/$FiO_2$ratio and COHb were $286.4{\pm}129.6mmHg$ and $7.8{\pm}6.6%$. Nine cases (24.3%) underwent endotracheal intubation and 3 cases (8.1%) underwent mechanical ventilation. The initial X-ray findings revealed abnormalities in, 18 cases (48.6%) with 15 (83.3%) of these being completely resolved. However, 3 (16.7%) of these had residual sequela. The initial pulmonary function test, showed an obstructive pattern in 9 (24.3%) with 4 (44.4%) of these showing a positive bronchodilator response, A restrictive pattern was also observed in 9 (24.3%) patients. A lower DLco was observed in only 4 (17.4%) patients of which 23 had undergone DLco. In the follow-up study, an obstructive and restrictive pattern was observed in only one (2.7%) case each. All the decreased DLco returned to mormal. Conclusions: Most surviving burn patients with an inhalation injury but with a small burn size showed initial derangements in the pulmonary function test that was restored to a normal lung function during the follow up period.

CComparative evaluation of the methods of producing planar image results by using Q-Metrix method of SPECT/CT in Lung Perfusion Scan (Lung Perfusion scan에서 SPECT-CT의 Q-Metrix방법과 평면영상 결과 산출방법에 대한 비교평가)

  • Ha, Tae Hwan;Lim, Jung Jin;Do, Yong Ho;Cho, Sung Wook;Noh, Gyeong Woon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.22 no.1
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    • pp.90-97
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    • 2018
  • Purpose The lung segment ratio which is obtained through quantitative analyses of lung perfusion scan images is calculated to evaluate the lung function pre and post surgery. In this Study, the planar image production methods by using Q-Metrix (GE Healthcare, USA) program capable of not only quantitative analysis but also computation of the segment ratio after having performed SPECT/CT are comparatively evaluated. Materials and Methods Lung perfusion scan and SPECT/CT were performed on 50 lung cancer patients prior to surgery who visited our hospital from May 1, 2015 to September 13, 2016 by using Discovery 670(GE Healthcare, USA) equipment. AP(Anterior Posterior)method that uses planar image divided the frontal and rear images into three rectangular portions by means of ROI tool while PO(Posterior Oblique)method computed the segment ratio by dividing the right lobe into three parts and the left lobe into two parts on the oblique image. Segment ratio was computed by setting the ROI and VOI in the CT image by using Q-Metrix program and statistically analysis was performed with SPSS Ver. 23. Results Regarding the correlation concordance rate of Q-Metrix and AP methods, RUL(Right upper lobe), RML(Right middle lobe) and RLL(Right lower lobe) were 0.224, 0.035 and 0.447. LUL(Left upper lobe) and LLL(Left lower lobe) were found to be 0.643 and 0.456, respectively. In the PO method, the right lobe were 0.663, 0.623 and 0.702, respectively, while the left lobe were 0.754 and 0.823. When comparison was made by using the Paired sample T-test, Right lobe were $11.6{\pm}4.5$, $26.9{\pm}6.2$ and $17.8{\pm}4.2$, respectively in the AP method. Left lobe were $28.4{\pm}4.8$ and $15.4{\pm}5.6$. The right lobe of PO had values of $17.4{\pm}5.0$, $10.5{\pm}3.6$ and $27.3{\pm}6.0$, while the left lobe had values of $21.6{\pm}4.8$ and $23.1{\pm}6.6$, thereby having statistically significant difference in comparison to the Q-Metrix method for each of the lobes (P<0.05). However, there was no statistically significant difference in Right middle lobe (P>0.05). Conclusion The AP method showed low concordance rate in correlation with the Q-Metrix method. However, PO method displayed high concordance rate overall. although AP method had significant differences in all lobes, there was no significant difference in Right middle lobe of PO method. Therefore, at the time of production of lung perfusion scan results, utilization of Q-Metrix method of SPECT/CT would be useful in computation of accurate resultant values. Moreover, it is deemed possible to expect obtain more practical sectional computation result values by using PO method at the time of planar image acquisition.

Comparison and Evaluation of the Effectiveness between Respiratory Gating Method Applying The Flow Mode and Additional Gated Method in PET/CT Scanning. (PET/CT 검사에서 Flow mode를 적용한 Respiratory Gating Method 촬영과 추가 Gating 촬영의 비교 및 유용성 평가)

  • Jang, Donghoon;Kim, Kyunghun;Lee, Jinhyung;Cho, Hyunduk;Park, Sohyun;Park, Youngjae;Lee, Inwon
    • The Korean Journal of Nuclear Medicine Technology
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    • v.21 no.1
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    • pp.54-59
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    • 2017
  • Purpose The present study aimed at assessing the effectiveness of the respiratory gating method used in the flow mode and additional localized respiratory-gated imaging, which differs from the step and go method. Materials and Methods Respiratory gated imaging was performed in the flow mode to twenty patients with lung cancer (10 patients with stable signals and 10 patients with unstable signals), who underwent PET/CT scanning of the torso using Biograph mCT Flow PET/CT at Bundang Seoul University Hospital from June 2016 to September 2016. Additional images of the lungs were obtained by using the respiratory gating method. SUVmax, SUVmean, and Tumor Volume ($cm^3$) of non-gating images, gating images, and additional lung gating images were found with Syngo,bia (Siemens, Germany). A paired t-test was performed with GraphPad Prism6, and changes in the width of the amplitude range were compared between the two types of gating images. Results The following results were obtained from all patients when the respiratory gating method was applied: $SUV_{max}=9.43{\pm}3.93$, $SUV_{mean}=1.77{\pm}0.89$, and $Tumor\;Volume=4.17{\pm}2.41$ for the non-gating images, $SUV_{max}=10.08{\pm}4.07$, $SUV_{mean}=1.75{\pm}0.81$, and $Tumor\;Volume=3.56{\pm}2.11$ for the gating images, and $SUV_{max}=10.86{\pm}4.36$, $SUV_{mean}=1.77{\pm}0.85$, $Tumor\;Volume=3.36{\pm}1.98$ for the additional lung gating images. No statistically significant difference in the values of $SUV_{mean}$ was found between the non-gating and gating images, and between the gating and lung gating images (P>0.05). A significant difference in the values of $SUV_{max}$ and Tumor Volume were found between the aforementioned groups (P<0.05). The width of the amplitude range was smaller for lung gating images than gating images for 12 from 20 patients (3 patients with stable signals, 9 patients with unstable signals). Conclusion In PET/CT scanning using the respiratory gating method in the flow mode, any lesion movements caused by respiration were adjusted; therefore, more accurate measurements of $SUV_{max}$, and Tumor Volume could be obtained from the gating images than the non-gating images in this study. In addition, the width of the amplitude range decreased according to the stability of respiration to a more significant degree in the additional lung gating images than the gating images. We found that gating images provide information that is more useful for diagnosis than the one provided by non-gating images. For patients with irregular signals, it may be helpful to perform localized scanning additionally if time allows.

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