• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.27-31
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• 2016

Purpose $^{99m}Tc-DMSA$ renal scan is a test for the comparison of the function by imaging the parenchyma of the kidneys by the cortex of a kidney and by computing the intake ratio of radiation by the left and right kidney. Since the distance between the kidneys and the bladder is not far given the bodily structure of an infant, the bladder is included in the examination domain. Research was carried out with the presumption that counts of bladder would impart an influence on the kidneys at the time of this renal scan. In consideration of the special feature that only a trace amount of a RI is injected in a pediatric examination, research on the method of injection was also carried out concurrently. Materials and Methods With 34 infants aged between 1 month to 12 months for whom a $^{99m}Tc-DMSA$ renal scan was implemented on the subjects, a Post IMAGE was acquired in accordance with the test time after having injected the same quantity of DMSA of 0.5mCi. Then, after having acquired an additional image by shielding the bladder by using a circular lead plate for comparison purposes, a comparison was made by illustrating the percentile of (Lt. Kidney counts + Rt. Kidney counts)/ Total counts, by drawing the same sized ROI (length of 55.2mm X width of 70.0mm). In addition, in the format of a 3-way stopcock, a Heparin cap and direct injection into the patient were performed in accordance with RI injection methods. The differences in the count changes in accordance with each of the methods were compared by injecting an additional 2cc of saline into the 3-way stopcock and Heparin cap. Results The image prior to shielding of the bladder displayed a kidney intake rate with a deviation of $70.9{\pm}3.18%$ while the image after the shielding of the bladder displayed a kidney intake rate with a deviation of $79.4{\pm}5.19%$, thereby showing approximately 6.5~8.5% of difference. In terms of the injection method, the method that used the 3-way form, a deviation of $68.9{\pm}2.80%$ prior to the shielding and a deviation of $78.1{\pm}5.14%$ after the shielding were displayed. In the method of using a Heparin cap, a deviation of $71.3{\pm}5.14%$ prior to the shielding and a deviation of $79.8{\pm}3.26%$ after the shielding were displayed. Lastly, in the method of direct injection into the patient, a deviation of $75.1{\pm}4.30%$ prior to the shielding and a deviation of $82.1{\pm}2.35%$ after the shielding were displayed, thereby illustrating differences in the kidney intake rates in the order of direct injection, a Heparin cap and the 3-way methods. Conclusion Since a substantially minute quantity of radiopharmaceuticals is injected for infants in comparison to adults, the cases of having shielded the bladder by removing radiation of the bladder displayed kidney intake rates that are improved from those of the cases of not having shielded the bladder. Although there are difficulties in securing blood vessels, it is deemed that the method of direct injection would be more helpful in acquisition of better images since it displays improved kidney intake rate in comparison to other methods.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.3
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• pp.222-228
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• 2008

Purpose: The objectives of this study were to compare the left ventricle ejection fraction (LVEF) from gated cardiac blood pool scan (GCBP) for analysis auto-drawing region of interest mode (AROI) and manual-drawing region of interest mode (MROI), respectively. To evaluation the relationships between values produced by both ROI modes. Materials and Methods: Gated cardiac blood pool scan using in vivo method Tc-99m Red Blood Cell were performed for 33 patients (mean age: $53.2{\pm}13.2\;y$) with objective of chemotherapy using single head gamma camera (ADAC Laboratories, Milpitas, CA). Left ventricular ejection fraction was automatically and manually measured, respectively. Results: There was significant difference statistically between AROI and MROI ($LVEF^{AROI}$: $71.4{\pm}12.4%$ vs. $LVEF^{MROI}$: $65.8{\pm}5.9%$, p=0.003). Intra-observer agreements in AROI was higher than MROI ($\gamma^{AROI}=0.964$, Cronbach's $\alpha^{AROI}=0.986$ vs. $\gamma^{MROI}=0.793$, Cronbach's $\alpha^{MROI}=0.911$), either. Additionally, there was no significant difference statistically at best septal view (${\Delta}LVEF^{BSV}=0.7{\pm}2.3%$, p=0.233), however statistically significant difference was found at badly separated septal view (${\Delta}LVEF=10.9{\pm}11.4%$, p=0.001). Moreover, Intra-observer agreements in best septal view was higher than badly separated septal view ($\gamma^{BSV}=0.939$, Cronbach's $\alpha^{BSV}=0.978$; $\gamma=0.948$, Cronbach's $\alpha=0.981$ at AROI, $\gamma^{BSV}=0.836$, Cronbach's $\alpha^{BSV}=0.936$; $\gamma=0.748$, Cronbach's $\alpha=0.888$ at MROI). Conclusion: When best septal view was acquired, LVEF by AROI and MROI indicated not different. Comparing Intra-observer agreements with AROI and MROI, the AROI tended to show higher. Therefore, it is considered that the AROI than MROI is valuable in reproducibility and objective when ROI analysis by acquire left ventricular of best septal view.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.24-30
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• 2009

Purpose: Today, Prostate cancer has been gradually increasing, according to the change of internal incidence rate of cancer. Generally, prostate cancer has lead to dead over 90%, in case of metastasis of lymph node and bone. So, innovative development of new radiopharmaceutical and imaging modality is progressed for detection of that metastasis, in nuclear medicine, now. Therefore, this study shows the usefulness of $^{18}F$-Fluoride PET/CT improved diagnosability on bone metastasis of prostate cancer. Materials and Methods: In this study, 33 male patients with prostate cancer were examined (The mean age: $67.8{\pm}10.2$ years old). Every patient was done each whole body bone scan (WBBS) and $^{18}F$-Fluoride positron emission tomography/computed tomography ($^{18}F$-Fluoride PET/CT). And then, using Receiver Operating Characteristic Curve (ROC curve), each sensitivity and specificity of two modalities was measured and compared with. Results: In 22 patients (66.6%) of all, bone metastasis was detected. And, in WBBS, sensitivity was 63.6%, specificity, 81.8%; in $^{18}F$-Fluoride PET/CT, sensitivity was 100% and specificity was 90.9%. As a result of ROC curve, AUROC (The Area under an ROC) of WBBS was 0.778, and that of $^{18}F$-Fluoride PET/CT, 0.942. Conclusions: $^{18}F$-Fluoride PET/CT was higher both sensitivity and specificity than WBBS, and it was valuable to detect bone metastasis of prostate cancer more definitely, with 3D imaging realization. Also, in $^{18}F$-Fluoride PET/CT, physiological images were acquired in more short time than WBBS, so, it was possible to reduce patient's waiting time and complaint. Therefore, it is considered that $^{18}F$-Fluoride PET/CT is able to improve diagnosability by offering more accurate images, as cuts in a share of high cost.

• The Korean Journal of Nuclear Medicine
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• v.33 no.4
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• pp.398-404
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• 1999

Purpose: Diabetic nephropathy is the most common cause of end stage renal disease and the incidence is progressively increasing. The aim of this study was to investigate the differences of $^{99m}Tc$-DMSA renal uptake among diabetic patients with normoalbuminuria, microalbuminuria and overt proteinuria, and then to determine the clinical usefulness of $^{99m}Tc$-DMSA in predicting early diabetic nephropathy Materials and Methods: $^{99m}Tc$-DMSA scan was performed and a total renal uptake of $^{99m}Tc$-DMSA was measured in 145 diabetic patients. Patients were divided into 3 groups according to the amount of 24 hour urinary albumin excretion as Group I (normoalbuminuria, 74 cases), Group II (microalbuminuria, 39 cases), and Group III (overt proteinuria, 32 cases). The differences of $^{99m}Tc$-DMSA renal uptake among the 3 groups and the correlation between the renal uptake of $^{99m}Tc$-DMSA and other clinical parameters were analyzed. Results: The total renal uptake of $^{99m}Tc$-DMSA of Group II ($40.8{\pm}11.0%$) was significantly lower than that of Group I ($54.4{\pm}6.3%$, p<0.001). The uptake of Group III ($27.7{\pm}12.0%$) was significantly lower than those of both Group I and Group II (p<0.001). $^{99m}Tc$-DMSA total renal uptakes correlated negatively with serum creatinine level (r=-0.629, p<0.001) and positively correlated with creatinine clearance rate (r=0.102, p<0.001). Conclusion: $^{99m}Tc$-DMSA total renal uptake of diabetic patients with microalbuminuria was significantly decreased compared with that of patients of normoalbuminuria. Therefore, $^{99m}Tc$-DMSA scan can be used as a diagnostic study for early detection of the diabetic nephropathy.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.45-50
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• 2011

Purpose: It appears the different value when the injection dose is calculating for patients on each PET/CT systems. It directly affects the technologists' radiation exposed dose. We studied the effect of the variable injection doses from several PET/CT systems to exposure dose for technologists. Materials and Methods: Six technologists have worked for 5 months through unit rotations with 3 PET/CT systems {Scanner 1 (S1): 0.15 mCi/kg, Scanner 2 (S2): 0.17 mCi/kg, Scanner 3 (S3): 0.12 mCi/kg}. Eighteen to 19 patients have had examinations per a day on each PET/CT systems. Examination parameters were adjusted to the same. TLDs were used for checking the exposure dose of technologists. Results: Each technologists' the monthly average exposure dose was as follows; S1: 0.76 mSv, S2: 0.93 mSv, S3: 0.47 mSv. The maximum exposure dose was 1.12 mSv, and minimum was 0.42 mSv. The results showed significance in the correlation between the PET/CT system and the exposure dose (p<0.005). Conclusion: When the amount of injection dose was small, the exposure dose was decreased not only the patients but also the technologists. The exposure dose was decreased by the individual proficiency of technologists. However, the low injection dose can highly reduce the exposure dose for technologist so that there will be needed to following studies.

• The Korean Journal of Nuclear Medicine
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• v.34 no.5
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• pp.410-417
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• 2000

Purpose: Idoxifene is currently entering phase II clinical trials for the treatment of advanced breast cancer. The radiolabeled idoxifene using $[^{123}I]$ provides an opportunity for clinical pharmacology with single photon emission computed tomography (SPECT). The purpose of this study was to prepare radiolabeled idoxifene using $[^{123}I]$ and to determine its cell uptake of breast cancer cell line. Materials and Methods: With a view to evaluating new anticancer drugs, we are investigating the novel antiestrogen pyrrolidino-4-iodotamoxifen (idoxifene). $[^{123}I]$Idoxifene has been prepared in no-carrier-added form using a tributyl stannylated precursor which has been synthesized by means of (2-chloroethoxy)benzene with (${\pm}$)-2-phenylbutanoic acid on the basis of previously reported standard methods. The biodistribution and dynamic behavior of the compound were investigated using the comparative breast cancer cell line, MCF-7 (estrogen receptor-positive) and MDA-MB-468 (non-estrogen receptor). Results and Conclusion: Acylation of (2-chloroethoxy)benzene with (${\pm}$)-2-phenylbutanoic acid gave the versatile ketone (81%) which reacted with 1,4-diiodobenzene to give triphenylethylene as a mixture of E and Z geometric isomers, which were separated by the recrystallization in ethanol. The E-isomer was treated with pyrrolidine to give idoxifene (67%). In order to incorporate radioactive iodine into the 4-position, the 4-stannylated precursor was prepared (30%). The yield of radioiodination was 90-92% with a high radiochemical purity greater than 98%. The ratio of tumor uptake of the breast cancer cell line between MCF-7 and MDA-MB-468 was about 1.7.

• Journal of radiological science and technology
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• v.39 no.2
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• pp.199-208
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• 2016

$^{99}mTc-MAG_3$ Renal scan is a method that acquires dynamic renal scan image by using $^{99}mTc-MAG_3$ and dynamically visualizes process of radioactive agent being absorbed to kidney and excreted continuously. Once the test starts, ratio in both kidneys in 1~2.5 minutes was measured to obtain split renal function and split renal function can be expressed in ratio based on overall renal function. This study is based on compares split renal function obtained from data acquired from posterior detector, which is a conventional renal function test method, with split renal function acquired from the geometric mean of values obtained from anterior and posterior detectors, and studies utility of attenuation compensation depending on difference in geometric mean kidney depth. From July, 2015 to February 2016, 33 patients who undertook $^{99}mTc-MAG_3$ Renal scan(13 male, 20 female, average age of 44.66 with range of 5~70, average height of 160.40cm, average weight of 55.40kg) were selected as subjects. Depth of kidney was shown to be 65.82 mm at average for left and 71.62 mm at average for right. In supine position, 30 out of 33 patients showed higher ratio of deep-situated kidney and lower ratio of shallow-situated kidney. Such result is deemed to be due to correction by attenuation between deep-situated kidney and detector and in case where there is difference between the depth of both kidneys such as, lesions in or around kidney, spine malformation, and ectopic kidney, ratio of deep-situated kidney must be compensated for more accurate calculation of split renal function, when compared to the conventional test method (posterior detector counting).

• The Korean Journal of Nuclear Medicine
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• v.30 no.3
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• pp.372-378
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• 1996

In the case of $^{123}I$ from the $^{124}Te$(p,2n)reaction, the radionuclidic impurity is the high-energy gamma-emitting $^{124}I$, which interferes greatly with nuclear medicine images. The choice of a collimator can affect the quality of clinical SPECT images of [I-123]MIBG, [I-123] ${\beta}$-CIT, or [I-123]IPT. The tradeoffs that two different collimators make among spatial resolution, sensitivity, and scatter were studied by imaging a line source at 5cm, 10cm, 15cm distance using a number of plexiglass sheets between source and collimator, petri dish, two-dimensional Hoffman brain phantom, Jaszczak phantom, and three-dimensional Hoffman brain phantom after filling with $^{123}I$. (FWHM, FWTM, Sensitivity) for low-energy ultrahigh-resolution parallel - hole (LEUHRP) collimator and medium- energy general - purpose (MEGP) collimator were measured as (9.27mm, 61.27mm, $129CPM/{\mu}Ci$) and (10.53mm, 23.17mm, $105CPM/{\mu}Ci$), respectively. The image quality of two-dimensional Hoffman brain phantom with LEUHRP looked better than the one with MEGP. However, the image quality of Jaszczak phantom and three-dimensional Hoffman brain phantom with LEUHRP looked much worse than the one with MEGP because of scatter contributions in three-dimensional imaging situation. The results suggest that the MEGP is preferable to LEUHRP for three-dimensional imaging studies of [I-123]MIBG, [I-123] ${\beta}$-CIT, or [I-123]IPT.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.73-77
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• 2014

Purpose Find out about the significance of the GFR values calculated by the kidney depth is measured by comparing the values obtained for kidney depth was measured GFR in the CT image kidney depth and is calculated by Tonnesen law in $^{99m}Tc$-DTPA dynamic kidney scan with each applies. Materials and Methods Among patients with normal value (75~120 mL/min) computed GFR conducted of dynamic renal scan to visit from February 2013 to February 2014 and donor GFR values in patients with normal value. The mean age was 46.9 years with 14 men 13 females. We used abdomen CT image which checked before conducting dynamic Kidney scan for measuring the depth of kidney. We only used CT image that contains renal hilum and measured outermost front of the kidney from the skin surface (a) and the final surface (b) caculated the average depth of [(a + b) / 2] respectively. Using the same ROI in order to limit the change in GFR values by the other additional element was set before and after the depth value was excluded from the GFR falls kidney disease. Results Using Tonnesen law the average value was caculated 5.94 cm from the right kidney 5.90 cm from the left kidney. It was 6.83 cm, 8.71 cm in the left kidney and the right kidney average value of the depth measured on the basis of the CT image. The respective increase in left kidney 0.93 cm and right kidney 2.77 cm calculated on the basis of CT image actually measured values. GFR was calculated as the average depth of the subject calculated by the method Tonnesen $83.3{\pm}9.79mL/min$. $98.6{\pm}14.07mL/min$ GFR was applied to calculate the average depth of the subjects using the CT image, is the difference appears 15.26 mL/min was increased after seting up depth value, P value was less than 0.01 which is significant. Conclusion The difference between GFR before-after setting up depth value cause that the different of depth value. Is a measured depth of the extension value of the calculated estimates Whereas Tonnesen kidney depth method is to use in calculating the value of GFR in a typical dynamic elongation test depth derived using the CT image depth. Is thought to be able to calculate more accurately the GFR value by the distance to the center of kidney more accurately measured in the skin thereby.

• Journal of Yeungnam Medical Science
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• v.19 no.2
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• pp.107-115
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• 2002

Purpose: Ga-67 scintigraphy has been used for the evaluation of tumors, especially lymphoma. Recently, Tl-201 and Tc-99m MIBI were also used to tumor imaging. Tl-201 and Tc-99m MIBI had better physiologic characteristics than Ga-67, so we studied 32 biopsy proven lymphoma patients (male 24, female 8, mean age 46 years) with Ga-67, Tl-201 or Tc-99m MIBI and compared the scan findings. Materials and Methods: Twenty-three of 32 patients were injected 74-111 MBq (2-3 mCi) of Tl-201, before chemotherapy and imaged with dual-headed SPECT (Prism 2000, Picker, USA) at 30 minutes after injection. Delayed images were obtained after 3 hr in 8 patients. Twenty seven of 32 patients were injected 740 MBq (20 mCi) of Tc-99m MIBI and imaged at 30 minutes after injection. 111-185 MBq (3-5 mCi) of Ga-67 was injected in 12 patients and imaged at 48 and 72 hours after injection. Twenty eight patients were diagnosed as non-Hodgkin's lymphoma and others were Hodgkin's lymphoma. Results: Twenty patients were positive on Tl-201 scan and 3 patients showed negative findings. One of these 3 patients, Tc-99m MIBI and Ga-67 scan were positive. Twenty two patients were positive on Tc-99m MIBI scan and 5 patients showed negative findings. One of these 5 patients, Tl-201 was positive and 2 were positive on Ga-67 scan. Ten of 12 patients showed positive findings on Ga-67 scan. The sensitivity of these agents were 83.3%, 87.0% and 81.5% for Ga-67, Tl-201 and Tc-99m MIBI, respectively. The sensitivity was highest in Tl-201 scan, but there were no significant differences among three tests. In this study, there was no significant difference of uptake ratios between early and delayed images of Tl-201. Conclusion: Scintigraphy with Tl-201 and Tc-99m MIBI in lymphoma patients have similar sensitivity with Ga-67.