• Title/Summary/Keyword: 핵의학 검사

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We Nuclear Physicians might have used the Term 'Activity' of Pulmonary Tuberculosis differently from Clinicians Who Treat Patients with Tuberculosis (폐결핵의 활동성 판정에 $^{99m}Tc$-MIBI 스캔을 이용할 때 있어서 용어상의 오해)

  • Park, Seok-Gun;Park, Jae-Seuk
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.2
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    • pp.129-134
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    • 2000
  • Purpose: It is difficult to determine the activity of tuberculosis radiologically. Therefore there have been efforts to assess the activity using radiopharmaceuticals such as $^{67}Ga,\;^{99m}Tc-tetrofosmin,\;and\;^{99m}Tc-MIBI$. But there may be some discrepancy in defining the term 'activity' between clinicians and nuclear physicians. While negative conversion of sputum acid fast bacilli (AFB) is defined as 'disappearance of activity' by clinicians, a loss of uptake in previously positive lesion is accepted as 'disappearance of activity' by nuclear physicians. We designed a prospective study to see if the negative conversion of sputum AFB could directly match the disappearance of radioactivity of the lesion. Materials and Methods: Fifteen patients with bacteriologically confirmed active localized pulmonary tuberculosis were scanned 10 and 60 min after intravenous injection of 550 MBq $^{99m}Tc$-MIBI. In 6 patients, who showed negative conversion of sputum AFB after 3-7 months of chemotherapy, $^{99m}Tc$-MIBI scan was repeated. For the purpose of comparison, target/nontarget ratios of the lesions were determined. Results: 12/15 (80%) patients with active pulmonary tuberculosis showed increased uptake of $^{99m}Tc$-MIBI in tuberculous lesion. After negative conversion of sputum AFB, 5/6 (83%) patients still showed increased uptake, although the intensity of uptake decreased. Conclusion: Uptake of radioactivity decreased but did not disappear after negative conversion of sputum AFB. $^{99m}Tc$-MIBI scan may be useful to address the degree of inflammation of pulmonary tuberculous lesion, but the uptake did not directly match the activity defined by positivity of sputum AFB. We nuclear physicians might have used the term 'activity' somewhat differently from clinicians who treat patients with tuberculosis.

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The Performance Improvement by Using a Role Model (역할 모델(Role model)을 이용한 업무 개선 - 업무의 달인(達人)을 찾아라 -)

  • Jung, Woo-Young;Ryu, Jae-Kwang;Kim, Kyung-Sik
    • The Korean Journal of Nuclear Medicine Technology
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    • v.12 no.3
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    • pp.199-207
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    • 2008
  • Purpose: The purpose of a role model is to find a master or expert who conduct their business effectively and work as a model that helps staff in charge to conduct their works effectively. This process is an effort to find out the deviation of work performance capability among staffs in charge and settle the work process to be optimized to practical business, the standardization of protocol. Materials and Methods: Seoul Asan medical center nuclear department developed 6~7 role modeling items and has applied it to work. I report two operation improvement cases we had applied a role model to Seoul ASAN medical center. Result: By comparison with none application of a role model, we could improve operation efficiency. Conclusion: The main purpose of role modeling is to make the employees who do the business in their charge effectively as a role model and contribute to work performance of employees who are lack of work performance although they performed their works hard. Our team is going to develop role model items continuously and to make a use of it to practical work then improve work performance. We regard it as a useful tool to performance improvement. The performance improvement by using a role model was very useful instrument.

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A Study on Availability about Positron Emission Mammography of Breast Cancer (유방암 환자의 Positron Emission Mammography에서의 유용성에 관한 연구)

  • Kim, Seung-Jeong;Kim, Jae-Il;Kim, Jin-Eui;Kim, Hyun-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.60-64
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    • 2010
  • Purpose: Until now the general study for breast cancer patient has been mammography, breast sonography for anatomic diagnostics and $^{18}F$-FDG whole body PET for functional one. But the PEM (Positron Emission Mammography) was developed to increase sensitivity, specificity and accuracy to improve the disadvantage of each study. Therefore this present study aims to describe availability of PEM for improving diagnosis of breast cancer. Materials and Methods: During 3 months from January in 2010, PEM was performed on 100 patients who had history of breast cancer. Using Naviscan's PEM Flex Solo II scanner, PEM images of breast were acquired. And then we evaluated sensitivity, specificity and accuracy of PEM data by comparing results of PEM images with postoperative pathologic finding. Results: On the 100 patients, it could reveal 89 true positive, 9 false positive, 7 false negative and 87 true negative. Thus the results of sensitivity, specificity and accuracy for PEM was evaluated 92.7%, 90.6% and 91.7%. Conclusion: The sensitivity, specificity and accuracy have been reported 83.7%, 68.5% and 77.1% in mammography, and that was 89.1%, 79.1% and 83.4% in breast sonography. However the results of PEM were more increased than others. Therefore the results of this study will be available that PEM used diagnosis with breast cancer, used preoperative operation plan and helps to discovery of a part recurrence.

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The Prevention of Carryover in the Automated System With Fixed Tips (자동 분주기 Fixed Tip의 Carryover 방지를 위한 개선 방안)

  • Hwang, Bo-Ra;Au, Doo-Hee;Bae, Jin-Su;Park, Jong-O;Kim, Ji-Young;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.3
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    • pp.181-184
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    • 2009
  • Purpose: Automated system that immunoassay examination are used widely. However, sample to sample carryover can cause that the next patient sample is false positive. Materials and Methods: We test HBs Ag, HBs Ab, HBc Ab(IgG) with Automated pipetting system (Tecan). It was placed with very high concentrations followed by saline solution. During this experiment, The fixed tip of Automated system wash With 0.25 moL/L NaOH. The Measurement results of saline solution confirm the occurrence of carryover. Results: Results of saline solution with 0.25 moL/L NaOH cleaning process was measured 100% negative, And results of patient serum with 0.25 moL/L NaOH cleaning process is similar reported results. Conclusion: As Results, 0.25 moL/L NaOH cleaning process was avoid carryover in experiment, And we know results of the hepatitis test did not affected by this solution we recommend 0.25 moL/L NaOH cleaning process as the Prevention of carryover in the automated system with fixed Tips.

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Giant Cell Tumor of the Proximal Fibula Treated by En Bloc Resection (전 절제술로 치료한 근위 비골의 거대 세포종)

  • Suh, Jeung-Tak;Choi, Sung-Jong;Kim, Young-Goun;Kim, Jeung-Il;Kim, Hui-Taek;Yoo, Chong-Il
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.200-205
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    • 2003
  • Purpose: To report our experiences of clinical features, treatment method and results of giant cell tumor of 5 patients in proximal fibula. Materials and Methods: Five patients managed with an en bloc resection preserving common peroneal nerve and lateral collateral ligament reconstruction with biceps femoris tendon followed up between January 1997 and July 2001. Preoperative plain radiograph and MRI and bone scan were checked. The recurrence of the tumor was judged by plain radiograph and clinical signs. Lateral instability of knee joint was checked during the outpatient follow-up. Results: The mean age of the patients at the time of operation was twenty- three (21-29). There were one male and four female patients. Dull pain was main symptom and palpable mass was seen in two patients. Peroneal nerve palsy and local recurrence were not observed except one case of temporary peroneal nerve palsy. During the outpatient follow up, one among 5 patients showed slight lateral instability and the other 4 patients showed no instabililty. Conclusion: Giant cell tumor in proximal fibula managed with an en bloc resection preserving common peroneal nerve and lateral collateral ligament reconstruction with biceps femoris tendon showed favorable results.

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Usefulness of applying Macro for Brain SPECT Processing (Brain SPECT Processing에 있어서 Macro Program 사용의 유용성)

  • Kim, Gye-Hwan;Lee, Hong-Jae;Kim, Jin-Eui;Kim, Hyeon-Joo
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.35-39
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    • 2009
  • Purpose: Diagnostic and functional imaging softwares in Nuclear Medicine have been developed significantly. But, there are some limitations which like take a lot of time. In this article, we introduced that the basic concept of macro to help understanding macro and its application to Brain SPECT processing. We adopted macro software to SPM processing and PACS verify processing of Brain SPECT processing. Materials and Methods: In Brain SPECT, we choose SPM processing and two PACS works which have large portion of a work. SPM is the software package to analyze neuroimaging data. And purpose of SPM is quantitative analysis between groups. Results are made by complicated process such as realignment, normalization, smoothing and mapping. We made this process to be more simple by using macro program. After sending image to PACS, we directly input coordinates of mouse using simple macro program for processes of color mapping, adjustment of gray scale, copy, cut and match. So we compared time for making result by hand with making result by macro program. Finally, we got results by applying times to number of studies in 2007. Results: In 2007, the number of SPM studies were 115 and the number of PACS studies were 834 according to Diamox study. It was taken 10 to 15 minutes for SPM work by hand according to expertness and 5 minutes and a half was uniformly needed using Macro. After applying needed time to the number of studies, we calculated an average time per a year. When using SPM work by hand according to expertness, 1150 to 1725 minutes (19 to 29 hours) were needed and 632 seconds (11 hours) were needed for using Macro. When using PACS work by hand, 2 to 3 minutes were needed and for using Macro, 45 seconds were needed. After applying theses time to the number of studies, when working by hand, 1668 to 2502 minutes (28 to 42 hours) were needed and for using Macro, 625 minutes (10 hours) were needed. Following by these results, it was shown that 1043 to 1877 (17 to 31 hours were saved. Therefore, we could save 45 to 63% for SPM, 62 to 75% for PACS work and 55 to 70% for total brain SPECT processing in 2007. Conclusions: On the basis of the number of studies, there was significant time saved when we applied Macro to brain SPECT processing and also it was shown that even though work is taken a little time, there is a possibility to save lots of time according to the number of studies. It gives time on technologist's side which makes radiological technologist more concentrate for patients and reduce probability of mistake. Appling Macro to brain SPECT processing helps for both of radiological technologists and patients and contribute to improve quality of hospital service.

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Study on the Breast Tissue Uptake according to Body Temperature on Molecular Breast Imaging (Molecular Breast Imaging 검사 시 체온 변화에 따른 유방 섭취율에 관한 고찰)

  • Kim, Ji Hyun;Baek, Song Ee;Oh, Shin Hyun;Ham, Jun Cheol;Kang, Chun Goo;Kim, Jae Sam
    • The Korean Journal of Nuclear Medicine Technology
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    • v.23 no.2
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    • pp.20-24
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    • 2019
  • Purpose Molecular Breast Imaging (MBI) scan is used in nuclear medicine, for which $^{99m}Tc-sestaMIBI$ is administered by intravenous injection. However, the breast uptake rate of $^{99m}Tc-sestaMIBI$ is less than 1% of the total dose administered, relying on blood flow conditions of organs. The purpose of this study is to evaluate the impact of changes to body temperature on the uptake of $^{99m}Tc-sestaMIBI$ in breast tissue. Materials and Methods We investigated 30 breast cancer patients who performed more than one follow-up MBI scan. All scans were acquired by Discovery 750B (Genral Electric Healthcare, USA). $^{99m}Tc-sestaMIBI$ injected with 740 MBq (20 mCi), after 60 minutes, gained bilateral breast CC (CranioCaudal), MLO (Medio Lateral Oblique) View. The follow-up examination was then classified into 15 body temperature control group and 15 body temperature non-control group, and gained breast image in the same way as before. The breast uptake rate was analyzed in the MLO View of the opposite side of the lesion, and blind images were evaluated. Results The breast uptake rate increased by 30.31% in the body temperature control group and it was statistically significant(P<0.05), and 0.96% in the body temperature non-control group, and it was not statistically significant(P=0.955). There was a significant difference in the uptake rate between the body temperature control and the non-control group of P value of 0.01. Evaluation of blind images showed significant results in terms of the quality of the images. Conclusion Increased breast tissue uptake was observed when the subject was kept warm. When the body temperature was raised after injection, dilation of the peripheral blood vessels can be achieved. As a result, the blood flow became smooth and the breast uptake rate increased. In addition, an increase in breast tissue uptake will improve the quality of images.

Gerstmann-Sträussler-Scheinker Disease: A Case Report (Gerstmann-Sträussler-Scheinker병: 증례 보고)

  • Minji Shin;Donghyun Kim;Young Jin Heo;Jin Wook Baek;Suyoung Yun;Hae Woong Jeong
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.745-749
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    • 2023
  • Gerstmann-Sträussler-Scheinker (GSS) disease is a rare hereditary prion disease which is clinically characterized by a progressive cerebellar ataxia followed by cognitive impairment. We report a rare case of GSS disease in a 39-year-old male patient who complained of a progressive gait disturbance followed by dysarthria with cognitive impairment, after five months from the onset of initial symptom. His brain MRI scan revealed multifocal symmetric diffusion restricted lesions with T2/FLAIR hyperintensities in bilateral cerebral cortices, basal ganglia, and thalami. His family members also manifested similar symptoms in their 40-50s, suggesting the possibility of a genetic disease. Finally, he was genetically diagnosed with GSS disease by real-time quaking-induced conversion and prion protein (PRNP) gene sequencing test.

The Effects of Discrepancy in Reconstruction Algorithm between Patient Data and Normal Database in AutoQuant Evaluation: Focusing on Half-Time Scan Algorithm in Myocardial SPECT (심근 관류 스펙트에서 Half-Time Scan과 새로운 재구성법이 적용된 정상군 데이터를 기반으로 한 정량적 분석 결과의 차이 비교)

  • Lee, Hyung-Jin;Do, Yong-Ho;Cho, Seong-Wook;Kim, Jin-Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.122-126
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    • 2014
  • Purpose: The new reconstruction algorithms (NRA) provided by vendor aim to shorten the acquisition scan time. Whereas depending on the installed version AutoQuant program used for myocardial SPECT quantitative analysis did not contain the normal data that NRA is applied. Thus, the purpose of this paper is to compare the results according to AutoQuant versions in myocardial SPECT applied NRA and half-time scan (HT). Materials and Methods: Rest Tl and stress MIBI data of total 80 (40 men, 40 women) patients were gathered. Data were applied HT acquisition and ASTONISH (Philips) software which is NRA. Modified autoquant of SNUH and old version of AutoQuant (full-time scan) provided by company were compared. Comparison groups were classified as coronary artery disease (CAD), 24 hrs delay and almost normal patients who have a simple pain patient. Perfusion distribution aspect, summed stress score (SSS), summed rest score (SRS), extent and total perfusion deficit (TPD) of each 25 patient who have above diseases were compared and evaluated. Results: The case of CAD, when using re-edited AutoQuant (HT) SSS and SRS showed about 30% reduction (P<0.0001), Extent showed about 38% reduction and TPD showed about 30% reduction in the tendency (P<0.0001). In the score of the perfusion, especially on the part of infero-medium, infero-apical, lateral-medium and lateral-apical regions were the biggest change. The case of the 24 hrs delay patient SRS (P=0.042), Extent (P=0.018) and TPD (P=0.0024) showed about 13-18% reduction. And the case of simple pain patient, comparison of 4 results showed about 5-7% reduction. Conclusion: This study was started based on expectation that results could be affected by normal patient data. Normal patient data is possible to change by race and gender. It was proved that combination of new reconstruction algorithm for reducing scan time and analysis program according to scan protocol with NRA could also be affected to results. Clinical usefulness of gated myocardial SPECT is possibly increased if each hospital properly collects normal patient data for their scan acquisition protocol.

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Study of External Radiation Expose Dose on Hands of Nuclear Medicine Workers (핵의학 종사자에서 손 부위의 외부 피폭선량 연구)

  • Park, Jun-Chul;Pyo, Sung-Jae
    • Journal of radiological science and technology
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    • v.35 no.2
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    • pp.141-149
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    • 2012
  • The aims of this study are to assess external radiation exposed doses of body and hands of nuclear medicine workers who handle radiation sources, and to measure radiation exposed doses of the hands induced by a whole body bone scan with high frequency and handling a radioactive sources like $^{99m}Tc$-HDP and $^{18}F$-FDG in the PET/CT examination. Skillful workers, who directly dispense and inject from radiation sources, were asked to wear a TLD on the chest and ring finger. Then, radiation exposed dose and duration exposed from daily radiation sources for each section were measured by using a pocket dosimeter for the accumulated external doses and the absorbed dose to the hands. In the survey of four medical institutions in Incheon Metropolitan City, only one of four institutions has a radiation dosimeter for local area like hands. Most of institutions uses radiation shielding devices for the purpose of protecting the body trunk, not local area. Even some institutions were revealed not to use such a shielding device. The exposed doses on the hands of nuclear medicine workers who directly handles radioactive sources were approximately twice as much as those on the body. The radiation exposure level for each section of the whole body bone scan with high frequency and that of the PET/CT examination showed that radiation doses were revealed in decreasing order of synthesis of radioactive medicine and installation to a dispensing container, dispensing, administering and transferring. Furthermore, there were statistically significant differences of radiation exposure doses of the hands before and after wearing a syringe shielder in administration of a radioactive sources. In this study, although it did not reach the permissible effective dose for nuclear medicine, the occupational workers were exposed by relatively higher dose level than the non-occupational workers. Therefore, the workers, who closely exposed to radioactive sources should be in compliance with safety management regulations, and take actions to maximally reduce locally exposed dose to hands monitoring with ring TLD.