• Journal of the Korean Society of Radiology
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• v.15 no.4
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• pp.533-538
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• 2021

^99mTcO₄^- is used to measure thyroid uptake. When measuring background radioactivity of the thigh, the distance between the detector and the thigh was 20 cm at a position 10 cm above the knee from the knee to the pelvis. At 25 cm, many hospitals are measuring at different distances. The purpose of this study was to study the difference in effectiveness in obtaining the thyroid uptake rate by quantitatively analyzing the uptake rate measurement at two distances. As a result, the average thyroid uptake rate measured at 20 cm in the thigh of 50 patients was 3.532±4.312%, and the average thyroid uptake rate measured at 25 cm was 3.680±4.304%. As a result of the thyroid uptake rate test result, the femoral background radioactivity value measured at a distance of 20 cm was relatively higher than the background radioactivity value measured at a distance of 25 cm, and as a result, the thyroid uptake rate was 0.148% lower.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.43-48
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• 2014

Purpose: In the PET/CT images, The SUV (standardized uptake value) enables the quantitative assessment according to the biological changes of organs as the index of distinction whether lesion is malignant or not. Therefore, It is too important to enter parameters correctly that affect to the SUV. The purpose of this study is to evaluate an allowable error range of SUV as measuring the difference of results according to input errors of Activity, Weight, uptake Time among the parameters. Materials and Methods: Three inserts, Hot, Teflon and Air, were situated in the 1994 NEMA Phantom. Phantom was filled with 27.3 MBq/mL of 18F-FDG. The ratio of hotspot area activity to background area activity was regulated as 4:1. After scanning, Image was re-reconstructed after incurring input errors in Activity, Weight, uptake Time parameters as ${\pm}5%$, 10%, 15%, 30%, 50% from original data. ROIs (region of interests) were set one in the each insert areas and four in the background areas. $SUV_{mean}$ and percentage differences were calculated and compared in each areas. Results: $SUV_{mean}$ of Hot. Teflon, Air and BKG (Background) areas of original images were 4.5, 0.02. 0.1 and 1.0. The min and max value of $SUV_{mean}$ according to change of Activity error were 3.0 and 9.0 in Hot, 0.01 and 0.04 in Teflon, 0.1 and 0.3 in Air, 0.6 and 2.0 in BKG areas. And percentage differences were equally from -33% to 100%. In case of Weight error showed $SUV_{mean}$ as 2.2 and 6.7 in Hot, 0.01 and 0.03 in Tefron, 0.09 and 0.28 in Air, 0.5 and 1.5 in BKG areas. And percentage differences were equally from -50% to 50% except Teflon area's percentage deference that was from -50% to 52%. In case of uptake Time error showed $SUV_{mean}$ as 3.8 and 5.3 in Hot, 0.01 and 0.02 in Teflon, 0.1 and 0.2 in Air, 0.8 and 1.2 in BKG areas. And percentage differences were equally from 17% to -14% in Hot and BKG areas. Teflon area's percentage difference was from -50% to 52% and Air area's one was from -12% to 20%. Conclusion: As shown in the results, It was applied within ${\pm}5%$ of Activity and Weight errors if the allowable error range was configured within 5%. So, The calibration of dose calibrator and weighing machine has to conduct within ${\pm}5%$ error range because they can affect to Activity and Weight rates. In case of Time error, it showed separate error ranges according to the type of inserts. It showed within 5% error when Hot and BKG areas error were within ${\pm}15%$. So we have to consider each time errors if we use more than two clocks included scanner's one during the examinations.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.111-114
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• 2010

Purpose: There has been recent interest in the radioactivity uptake and image acquisition of radioactivity concentration. The degree of uptake is strongly affected by many factors containing $^{18}F$-FDG injection volume, tumor size and the density of blood glucose. Therefore, we investigated how radioactivity uptake in target influences 2D or 3D image analysis and elucidate radioactivity concentration that mediate this effect. This study will show the relationship between the radioactivity uptake and 2D,3D image acquisition on radioactivity concentration. Materials and Methods: We got image with 2D and 3D using 1994 NEMA PET phantom and GE Discovery(GE, U.S.A) STe 16 PET/CT setting the ratio of background and hot sphere's radioactivity concentration as being a standard of 1:2, 1:4, 1:8, 1:10, 1:20, and 1:30 respectively. And we set 10 minutes for CT attenuation correction and acquisition time. For the reconstruction method, we applied iteration method with twice of the iterative and twenty times subset to both 2D and 3D respectively. For analyzing the images, We set the same ROI at the center of hot sphere and the background radioactivity. We measured the radioactivity count of each part of hot sphere and background, and it was comparative analyzed. Results: The ratio of hot sphere's radioactivity density and the background radioactivity with setting ROI was 1:1.93, 1:3.86, 1:7.79, 1:8.04, 1:18.72, and 1:26.90 in 2D, and 1:1.95, 1:3.71, 1:7.10, 1:7.49, 1:15.10, and 1:23.24 in 3D. The differences of percentage were 3.50%, 3.47%, 8.12%, 8.02%, 10.58%, and 11.06% in 2D, the minimum differentiation was 3.47%, and the maximum one was 11.06%. In 3D, the difference of percentage was 3.66%, 4.80%, 8.38%, 23.92%, 23.86%, and 22.69%. Conclusion: The difference of accumulated concentrations is significantly increased following enhancement of radioactivity concentration. The change of radioactivity density in 2D image is affected by less than 3D. For those reasons, when patient is examined as follow up scan with changing the acquisition mode, scan should be conducted considering those things may affect to the quantitative analysis result and take into account these differences at reading.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.243-251
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• 2000

Purpose: This prospective study was performed to evaluate the usefulness of preoperative radioimmunoscintigraphy and intraoperative scintimetric examination (radioimmunoguided surgery: RIGS) using $^{99m}Tc-anti-CEA\;F(ab')_2$ fragment. Materials and Methods: Nineteen patients with rectal cancer underwent preoperative whole body planar scintigraphy at 4 hours after injection of $^{99m}Tc-anti-CEA\;F(ab')_2$ fragment and SPECT imaging at 18 hours. Surgical operation was performed at 24 hours after injection. During laparotomy, radioactivities from intraabdominal viscera were measured by gamma probe. The radioactivities from excised tumor and lymph nodes were also measured and compared with pathology. Results: All nineteen patients were confirmed to have adenocarcinomas in the rectum. Twenty-seven of 97 excised lymph node groups had metastasis and 2 patients had liver metastasis in pathology Preoperative radioimmunoscintigraphy detected primary tumors in 11 patients (sensitivity 55%) and it could not detect any lymph nodes or liver metastasis. All patients showed high radioactivity in the kidneys, liver, spleen, and major vessels in intraoperative measurement by gamma probe, and tumor activity was not discriminated from background activity However, radioactivity from excised tumor was higher than normal rectum (T/B ratio; $3.47{\pm}2.25$). When excised lymph node activity/background activity ratio >1.5 was considered as positive criteria of metastasis, sensitivity, specificity, positive and negative predictive values were 78.6%, 73.9%, 55.0% and 89.5%, respectively. Conclusion: Radioimmunoscintigraphy using $^{99m}Tc-anti-CEA\;F(ab')_2$ has no additional value for preoperative staging and use of early RIGS using $^{99m}Tc-anti-CEA\;F(ab')_2$ is inappropriate. For early RIGS using $^{99m}Tc$ labeled antibodies in rectal cancer patients, further development of more specific antibodies and methods to reduce background activity are needed.

• The Korean Journal of Nuclear Medicine
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• v.38 no.4
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• pp.306-310
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• 2004

Purpose: The aim was to assess how the background site affects the Gates' glomerular filtration rate(GFR) measurement using Tc-99m-DTPA in correlation with GFR by I-125-lothalamate method. Material and methods: The study populations were 63 adults with 39 men and 24 women aged from 20 to 59 yrs (mean=37.9 yrs). The fellowing five background regions of interest were used in measurement of GFR using Gates' method: 1) lower side of each kidney(subrenal), 2) around each kidney(circumferential), 3) upper side of each kidney(suprarenal), 4) lateral side of each kidney(lateral), 5) between the two kidneys(inter-renal). We also measured GFR using I-125-iothalamate in each subject. The two studies were separated by 1 to 3 weeks. The subjects were divided into two groups by renal depth. Group 1 with renal $depth{\geq}7cm$ and group 2 with renal depth<7cm. We calculated the means and standard deviations of the GFRs measured by two studies. And we statistically analyzed the correlation and differences among GFRs by Gates' method and the GFR by iothalamate method with correlation analysis. Results: The GFRs by Gates' method using suprarenal and inter-renal background correction showed better correlation with the GFR measured by I-125-iothalamate. And GFRs measured by Gates' method showed statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth<7cm. But GFRs measured by Gates' method did not show statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal $depth{\geq}7cm$. Conclusion: GFRs measured with Gates' method showed higher correlation with the GFR measured by I-125-iothalamate when the regions of interest were plated over the suprarenal and inter-renal backgrounds. And GFRs measured with Gates method showed statistically significant correlation with the GFR measured by I-125-iothalamate in the group with renal depth<7cm.

• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.1
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• pp.67-70
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• 2013

Purpose: Surge in patients with hepatocellular carcinoma, hepatic artery chemical embolization is one of the effective interventional procedures. The PET/CT examination plays an important role in determining the presence of residual cancer cells and metastasis, and prognosis after embolization. The other hand, the hepatic artery chemical embolization of embolic material used lipiodol produced artifacts in the PET/CT examination, and these artifacts results in quantitative evaluation influence. This study, the radioactivity density and the percentage error was evaluated by the extent of the impact of lipiodol in the image of PET/CT. Materials and Methods: 1994 NEMA Phantom was acquired for 2 minutes and 30 seconds per bed after the Teflon, water and lipiodol filled, and these three inserts into the enough to mix the rest behind radioactive injection with $20{\pm}10MBq$. Phantom reconfigure with the iterative reconstruction method the number of iterations for two times by law, a subset of 20 errors. We set up region of interest at each area of the Teflon, water, lipiodol, insert artifact occurs between regions, and background and it was calculated and compared by the radioactivity density(kBq/ml) and the% Difference. Results: Radioactivity density of the each region of interest area with the teflon, water, lipiodol, insert artifact occurs between regions, background activity was $0.09{\pm}0.04$, $0.40{\pm}0.17$, $1.55{\pm}0.75$, $2.5{\pm}1.09$, $2.65{\pm}1.16 kBq/ml$ (P <0.05) and it was statistically significant results. Percentage error of lipiodol in each area was 118%, compared to the water compared with the background activity 52%, compared with a teflon was 180% of the difference. Conclusion: We found that the error due to under the influence of the attenuation correction when PET/CT scans after lipiodol injection performed, and the radioactivity density is higher than compared to other implants, lower than background. Applying the nonattenuation correction images, and after hepatic artery chemical embolization who underwent PET/CT imaging so that the test should be take the consideration to the extent of the impact of lipiodol be.

• The Korean Journal of Nuclear Medicine
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• v.34 no.3
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• pp.234-242
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• 2000

Purpose: Tc-99m MIBI scintimammography has been validated as an useful non-invasive diagnostic tool for the primary breast cancer. But most studies have included small population of patients. We have experienced a large study population and investigated the diagnostic usefulness of Tc-99m MIBI scintimammography in detection of primary breast cancer and axillary lymph node metastasis. Materials and Methods: This study included 305 patients who underwent scintimammogtaphy for palpable breast masses or abnormal radiologic findings. Tc-99m MIBI scintimammography was performed 10 minutes after intravenous injection of 925 MBq of Tc-99m MIBI. If the early image revealed abnormal finding, 3 hour delayed image was also acquired. We calculated early and delayed lesion to non-lesion ratios (L/N). The pathologic diagnosis was obtained from surgical operation or FNAB and compared with the results of Tc-99m MIBI scintimammography. Results: Malignant breast diseases were 155 and benign ones were 150. Tc-99m MIBI scintimammography revealed 132 true positive, 23 false negative, 10 false positive, and 140 true negative cases. The sensitivity, specificity, positive predictive value and negative predictive value for the primary breast cancer detection were 85.2%, 93.4%, 92.9%, and 85.9%, respectively. The sensitivity, specificity, positive predictive and negative predictive values of Tc-99m MIBI scintimammography in detecting metastatic axillary lymph node involvement were 22%, 90.4%, 61.9% and 62.3%, respectively. Early L/N of malignant breast disease was significantly higher than that of benign one ($2.44{\pm}0.97\;vs\;1.94{\pm}0.78$, p=0.01). Delayed L/N had no significant difference between malignant and benign breast diseases ($1.94{\pm}0.52\;vs\;1.91{\pm}0.73$, p=0.43). Conclusion: Our study revealed that Tc-99m MIBI scintimammography was an useful diagnostic tool for the diagnosis of breast cancer. And early L/N ratio might provide complementary role in the detection of breast cancer. But the Tc-99m MIBI scintimammography had limited value in the detection of small breast cancer (less than 1 cm) and axillary lymph node metastasis.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.1
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• pp.52-58
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• 2016

Purpose Recent retrospective studies are being actively conducted to analyze the survival of patients with SUVmax, MTV, TLG, such as information from a variety of PET originating. However, there is no clear way is difficult to accurately measure the volume of the tumor may be the difference between the caster is raised. In this study, to evaluate compare the volume measuring methods according to the characteristics of the tumor. Materials and Methods 18F-saline to fill the NEMA IEC Body Phantom insert the volume of balance and imbalance in phantom were acquired to the Biograph truepoint 40 (Siemens medical system, Germany) PET/CT scanner. The ratio of the volume and Background was acquired as 3.0, 5.0, 8.0, 18, 40. Clinical patients were randomly selected 120 people in staging patients with cancer of the digestive system from the year 2010 until the year 2014. Measurement methods were used a 40% threshold, 50% threshold and gradient segmentation technique, i.e. PET EDGE. Five years of experience of the two radio-technologist and one doctor was measured by repeated three times. Analysis methods were Intraclass correlation coefficient and Pearson correlation. Results In Phantoms, the 40% threshold method gave the best concordance between measured and actual volumes (r = 0.992, 0.997). In clinical patient outcome agreement between observers EDGE it is as high as 0.999 (CI: 0.998-0.999). And there were no statistical significance of the difference between the measurements (P = 0.620). 40% threshold method showed the best correlation between the measurements (r = 0.953). Increasing the ratio of tumor to background decreased the influence of a measuring method. Conclusion How to measure volume of the tumor in the patient was clinically most useful is 50% and the lowest impact on the characteristics of the tumor. Therefore, to reduce the background of the patients in PET/CT scan, it should be required research and effort.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.98-103
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• 2014

Purpose: The effective half life of I-131 is useful to calculate radiation dose, period of hospitalization, and exposure dose of surrounding people from patient. However, it is difficult to measure. This study estimates the effective half life in whole body and thyroid in using of value of residual radioactivity obtained from the early and delay images of Dual time I-131 whole body scan. Also, the correlations between the effective half life and serum creatinine, GFR, and administration dose were investigated in this study. Materials and Methods: The targets were 50 patients administration high dose of I-131 from February to August in 2013, having normal range of serum creatinine and over $30{\mu}IU/mL$ of TSH levels. After administration radioactive I-131, the early scan in the 3rd day and the delay scan in the 5-6th days were performed. To measure the residual radioactivity in the whole body and thyroid, ROI was set and then background radioactivity was corrected to estimate. The effective half life was estimated by calculating the ratio of measured values between the early and delay images. To compare the effective half lives of the whole body and thyroid, it was analyzed by Independent t-test, and each correlation of the effective half life, GFR, serum creatinine, and the dose of administration were analyzed by calculating the pearson's correlation coefficient. All of the analysis were determined to be statistically significant when P<0.05. Results: The effective half life of the whole body was $17.06{\pm}5.50$ hours and of the thyroid was $17.22{\pm}5.41$ hours. The two effective half life did not show significant difference (P=0.887). As the value of GFR was increased, the effective half life of whole body (r=-0.407, P=0.003) and of thyroid (r=-0.473, P=0.001) were significantly decreased; as the value of serum creatinine was increased, the effective half life of whole body (r=0.309, P=0.029) and of thyroid (r=0.371, P=0.008) were significantly increased. In the administration dose, effective half life did not have correlations. Conclusion: The effective half life of I-131 of patients treated for their thyroids were estimated only by using the images of Dual time I-131 whole body scan. Also, the correlations with the effective life, GFR, and serum creatinine were examined. This study might be utilized for a study on optimization for the period of hospitalization of patients treated by high dose of I-131 and on evaluation for internal absorbed dose of MIRD schema in application of the effective half life.

• The Korean Journal of Nuclear Medicine
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• v.32 no.4
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• pp.382-390
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• 1998

Purpose: The purpose of this study was to evaluate the accuracy of radioactivity quantitation in Tc-99m SPECT by using combined scatter and attenuation correction. Materials and Methods: A cylindrical phantom which simulates tumors (T) and normal tissue (B) was filled with varying activity ratios of Tc-99m. We acquired emission scans of the phantom using a three-headed SPECT system (Trionix, Inc.) with two energy windows (photopeak window: $126{\sim}154keV$ and scatter window: $101{\sim}123keV$). We performed the scatter correction with dual-energy window subtraction method (k=0.4) and Chang attenuation correction. Three sets of SPECT images were reconstructed using combined scatter and attenuation correction (SC+AC), attenuation correction (AC) and without any correction (NONE). We compared T/B ratio, image contrast [(T-B)/(T+B)] and absolute radioactivity with true values. Results: SC+AC images had the highest mean values of T/B ratios. Image contrast was 0.92 in SC+AC, which was close to the true value of 1, and higher than AC (0.77) or NONE (0.80). Errors of true activity by SPECT images ranged from 1 to 11% for SC+AC, $22{\sim}47%$ for AC, and $2{\sim}16%$ for NONE in a phantom which was located 2.4cm from the phantom surface. In a phantom located 10.0cm from the surface, SC+AC underestimated by 24%, NONE 40%. However, AC overestimated by 10%. Conclusion: We conclude that accurate SPECT activity quantitation of Tc-99m distribution can be achieved by dual window scatter correction combind with attenuation correction.