• The Korean Journal of Nuclear Medicine
• /
• v.2 no.1
• /
• pp.15-19
• /
• 1968

정맥에 주사된 교양(膠樣) 방사성물질은 간(肝)에 있는 Kupffer 세포가 가진 탐식작용에 의해서 혈류로 부터 거의 완전히 제거된다. 이 원리는 정상인(正常入)과 간(肝)경변증환자에서 간(肝)혈류량을 측정하는데 이용된다. 일반적으로 간(肝)경변증때에는 간(肝)에서의 교양물질 추출율이 저하되기 때문에 혈중에서의 제거가 늦어진다하며, Shaldon 등은 혈중제거율측정을 이용하여, 추출율의 저하가 간내(肝內)에서 생기는 동맥과 정맥간의 단락(短絡) 때문에 초래되는 것을 증명하였다. 최근 혈중제거율을 몇가지 간(肝)질환을 진단하는데 이용한 보고가 나왔다. 그러나 그 방법에 대한 상세한 검토가 없었던 것 같다. 저자는 이번 연구에서 손쉽게 얻을 수 있는 교양$^{198}$금(金)을 사용하여 교양물질의 혈중제거율 측정방법을 검토하여 이 검사가 임상에서 통상적(通常的)으로 쓰일 수 있음을 밝혔다. (1) 정상인과 환자가 섞인 52명을 대상으로 동일인에서 $24{\sim}48$ 시간 간격을 두고 반복측정한 혈중제거율치의 오차는 통계학적으로 무시할 수 있었으며, 따라서 이측정은 근소한 오차한계내에서 되풀이할 수 있는 것을 알았다. (2) 정상인 172명에서 얻은 측정치를 토대로 하여 혈중제거율 정상치가 $3.31{\pm}0.73$분임을 알았다(교양 금(金) 입자의 크기에 따라 이 측청치는 달라진다). (3) 조직검사로 진단이 확정된 간(肝)경변증환자 23명을 조사하여 91.3%에서 혈중제거율이 정상한계를 넘어 연장(延長)되는 것을 알았다. 결론으로 혈중제거율검사는 임상에서 손쉽게 실시할 수 있는 간(肝)기능검사가 될 수 있다고 생각되며, 특히 간(肝)경변증을 진단하는데 도움이 된다고 믿는다.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.14 no.2
• /
• pp.166-171
• /
• 2010

Purpose: The SPECT/CT is able to acquire diagnostic information resolved the difficult problems that discriminate regions of focals by intergrating functional images and anatomical images. We introduce the usefulness of "Volumetrix Suite" which can describe 3D images by the convergence of the SPECT/CT images and reference CT images. Materials and Methods: We applied Volumetrix Suite program (Volumetrix IR, Volumetrix 3D) to patients, Bone, Venography, Parathyroid, WBC, taken diagnostic CT examination which have same regions of focal in Seoul Metropolitan Government Seoul National University Boramae Medical Center. After acquiring SPECT/CT images and reference CT images, we fused a couple of scans applying for this programs. The CT scan of Infinia Hawkeye 4 shows limitation of anatomical information. For this reason, we tried to transfer CT images that have lots of diagnostic informations as the form of Dicom file in PACS, and changed from 2D images to 3D images after image registering in Xeleris Workstaion of Hawkeye 4. Results & Conclusion: By using Volumetrix Suite program, we're able to acquire more accurate anatomical informations with 3D rendering which can distinguish both location and range of focals in Infinia Hawkeye 4. Thus, the result of utilizing this program indicate that nuclear medicine anatomical images can be improved by providing more diagnostic imformations produced by its program.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.22 no.1
• /
• pp.98-102
• /
• 2018

Purpose When examining patients with digestive system Leakage, it is not easy to distinguish between bile leakage and bleeding only with Planar images. I would like to evaluate the utility of leakage of bile, confirmation of gastrointestinal bleeding and location discrimination using SPECT-CT. Materials and Methods SPECT-CT was performed according to the request of the reading room after acquiring Planar image for a total of 13 patients, including 8 patients suspected of bile leakage and 5 patients suspected of gastrointestinal bleeding, among patients visiting this specification went. We used Symbia T16 from SIEMENS and Discovery 670 from GE. Planar and SPECT-CT images were evaluated with a score of 1 to 10 by 4 experienced nuclear medicine doctors. Using the sensitivity and the specificity, the evaluation of the inspection by the ROC curve was carried out. The final diagnosis was confirmed by follow-up observation as a result of reoperative surgery. Results The sensitivity, specificity and accuracy of SPECT-CT were 91.7%, 100% and 94.2%, respectively. Planar images were 83.3%, 68.8% and 78.8%, respectively. Planar images showed lower diagnostic accuracy compared to SPECT-CT (78.8%, 94.2%, p<0.05). Moreover, the reliability of the diagnosis of SPECT-CT by ROC curve analysis showed a more useful result than the Planar image (p<0.05). Conclusion SPECT-CT had high sensitivity and specificity for diagnosis of biliary leakage and gastrointestinal bleeding and location discrimination. When SPECT-CT is additionally performed together with Planar images, it may be considered to improve bile leakage and diagnosis of gastrointestinal bleeding patients and position discrimination evaluation. There is usefulness depending on the patient's age and position, but consideration of additional CT exposure may be done sufficiently.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.17 no.1
• /
• pp.18-24
• /
• 2013

Purpose: Myocardial perfusion SPECT using $^{201}Tl$ is an important method for viability of left ventricle and quantitative evaluation of cardiac function and now various reconstruction methods are used to improve the image quality. But in case of small sized heart, you should always be careful because of the Partial Volume Effect which may cause errors of quantitative indices at the reconstruction step. So, In this study, we compared those quantitative indices of left ventricle according to the reconstruction method of myocardial perfusion SPECT with the Echocardiography and verified the degree of the differences between them. Materials and Methods: Based on ESV 30 mL of Echocardiography, we divided 278 patients (male;98, female;188, Mean age;$65.5{\pm}11.1$) who visited the Asan medical center from February to September, 2012 into two categories; below the criteria to small sized heart, otherwise, normal or large sized heart. Filtered and output each case, we applied the method of FBP and OSEM to each of them, and calculated EDV, ESV and LVEF, and we conducted statistical processing through Repeated Measures ANOVA with indices that measured in Echocardiography. Results: In case of men and women, there were no significant difference in EDV between FBP and OSEM (p=0.053, p=0.098), but in case of Echocardiography, there were meaningful differences (p<0.001). The change of ESV especially women in small sized heard, significant differences has occurred among FBP, OSEM and Echocardiography. Also, in LVEF, there were no difference in men and women who have normal sized heart among FBP, OSEM and Echocardiography (p=0.375, p=0.969), but the women with small sized heart have showed significant differences (p<0.001). Conclusion: The change in quantitative indices of left ventricle between Nuclear cardiology image reconstruction, no difference has occurred in the patients with normal sized heart but based on ESV, under 30 mL of small sized heart, especially in female, there were significant differences in FBP, OSEM and Echocardiography. We found out that overestimated LVEF caused by PVE can be reduced in average by applying OSEM to all kinds of gamma camera, which are used in analyzing the differences.

• The Korean Journal of Nuclear Medicine Technology
• /
• v.15 no.1
• /
• pp.39-44
• /
• 2011

Purpose: $^{18}F$-FDG PET/CT has been known a useful modality to diagnose high-glucose-using cells such as cancer cells by glucose metabolism of FDG. Mainly, FDG takes on cancer and inflammatory cells; However, There have been FDG uptakes on normal tissues by individual physiological characteristics, occasionally. Especially, in fertile females, unusual FDG uptake of breast changes as the menstrual cycle, and disturb diagnosis. Therefore, the study aimed to evaluate the change of breast FDG uptake in menstrual cycle on $^{18}F$-FDG PET/CT. Materials and Methods: 160 females ($34{\pm}3.5$ years old) who do not undergo a gynecologic anamnesis and have regular menstrual cycle over the previous 6 months were examined, from March 2009 to February 2010. They were divided 4 groups (each 40 patients) as flow phase, proliferative phase, ovulatory phase and secretory phase using Pregnancy Calculator 0.14. and history taking. Discovery Ste (GE Healthcare, Milwaukee, Mi, USA) was used as PET/CT. We analyzed SUVs on accumulated region on breast, and 3 nuclear medicine specialists did the Blind test. Results: SUVs on the Breast were flow phase ($1.64{\pm}0.25$), proliferative phase ($0.93{\pm}0.28$), ovulatory phase ($1.66{\pm}0.26$) and secretory phase ($1.77{\pm}0.28$). It showed high uptake value in secretory, flow phase and ovulatory phase (p<0.05). In gross analysis, the accumulation of breast was divided into 3 grades as comparing with lung and liver. The breast's uptake was equal to lung (Grade I); between lung and liver (Grade II); equal to or greater than liver (Grade III). The results showed high uptake value in secretory, flow phase and ovulatory phase (p<0.05). Conclusion: In fertile females, FDG uptake of breast changed as menstrual cycle, and it available to diagnose breast disease. Therefore, we consider reducing false-negative finding of breast disease, by doing examination on appropriate period through history taking about individual menstrual cycle.

• Nuclear Medicine and Molecular Imaging
• /
• v.41 no.4
• /
• pp.309-316
• /
• 2007

Purpose: Sentinel lymph node biopsy became the standard procedure in early breast cancer surgery. Faculty members might be exposed to a trace amount of radiation. The aim of this study is to quantify the radiation exposure and verify the safety of the procedure and the facilities, especially during pathologic process. Materials and Methods: Sentinel lymph node biopsies with Tc-99m human serum albumin were performed as routine clinical work. Exposed radiation doses were measured in pathologic technologist, nuclear medicine technologist, and nuclear medicine physician using a thermoluminescence dosimeter (TLD) during one month. We also measured the residual radioactivities or absorbed dose rates, the exposure distance and time during procedure, the radiation dose of the waste and the ambient equivalent dose of the pathology laboratory. Results: Actual exposed doses were 0.21 and 0.85 (uSv/study) for the whole body and hand of pathology technologist after 47 sentinel node pathologic preparations were performed. Whole body exposed doses of nuclear medicine physician and technologist were 0.2 and 2.3 (uSv/study). According to this data and the exposure threshold of the general population (1 mSv), at least 1100 studies were allowed in pathology technologist. The calculated exposed dose rates (${\mu}$ Sv/study) from residual radioactivities data were 2.47/ 22.4 ${\mu}$ Sv (whole body/hand) for the surgeon; 0.22/ 0 ${\mu}$ Sv for operation nurse. The ambient equivalent dose of the pathology laboratory was 0.02-0.03 mR/hr. The radiation dose of the waste was less than 100 Bq/g and nearly was not detected. Conclusion: Pathologic procedure relating sentinel lymph node biopsy using radioactive colloid is safe in terms of the radiation safety.(Nucl Med Mol Imaging 2007;41(4);309-316)

• The Korean Journal of Nuclear Medicine Technology
• /
• v.13 no.1
• /
• pp.116-119
• /
• 2009

Background: Preanalytical factors can affect reliability of hormone assay results. Adrenocorticotropic hormone (ACTH) in blood is considered highly unstable because of proteolytic degradation, so storage of blood samples on ice until analysis is recommended. In clinical practice, however, this procedure may present logistical problems because most samples for ACTH measurement must be shipped from the place of sample collection to the laboratory. Therefore, we studied the impact of time and temperature before plasma separation and analysis on the results of ACTH assays. Methods: A total number of 22 patients were enrolled in this study. We obtained 2 blood samples. ACTH concentrations were 35~126 pg/mL. ACTH concentrations were measured by immunoradiometric assay (IRMA) using commercial kits (CIS Biointernational, Gif-sur-Yvette, France). Results: ACTH levels showed a significant difference between the samples of $22^{\circ}C$ EDTA and $4^{\circ}C$ EDTA. Measured ACTH concentrations significantly decreased with time before freezing at $-20^{\circ}C$. ACTH levels showed no significant difference between the groups of after storage for 24 hr without centrifugation at $22^{\circ}C$ and $4^{\circ}C$. Conclusion: We recommend that blood samples be obtained on pre-chilled EDTA collection tubes. The shortest possible time between sample collection and processing is always the best laboratory practice.

• Korean Journal of Clinical Laboratory Science
• /
• v.52 no.4
• /
• pp.349-355
• /
• 2020

Recently, the detection of Mycobacterium tuberculosis complex (MTBC) in respiratory specimens has decreased, and nontuberculous mycobacteria (NTM) has increased. This study examined the increase in NTM lung disease patients and their age and sex distribution compared to the increase in NTM detection in 132,359 respiratory specimens examined in a Gwangju Secondary Hospital from 2010 to 2019. Furthermore, the prevalence of pulmonary tuberculosis infection in NTM positive patients was investigated. The positive rates of the mycobacterial culture were 21.9% (1,624/7,403) in 2010 and 17.4% (1,937/11,161) in 2019. The NTM recovery rate increased from 38.0% (617/1,624) in 2010 to 72.4% (1,403/1,937) in 2019. The average diagnosis rate of NTM lung disease in the NTM positive patients was 27.1%. Among them, cases of current pulmonary tuberculosis infection decreased from 44.9% in 2010 to 23.4% in 2019, and cases of previous diagnosis or treatment decreased from 15.8% to 10.7%. Of all NTM lung diseases, 69.0% were in their 60s or older, with more females than males. In the future, according to aging and tuberculosis management policies, NTM detection is expected to increase while MTBC decreases and laboratories must pay close attention to this phenomenon and constantly monitor the test results.

• Korean Journal of Clinical Laboratory Science
• /
• v.55 no.4
• /
• pp.253-260
• /
• 2023

The germanium-68/gallium-68 (⁶⁸Ge/⁶⁸Ga) generator has high spatial utilization and requires little maintenance, making it economical and easy to produce. Thus, the frequency of use of ⁶⁸Ga radiopharmaceuticals is rapidly increasing worldwide. Therefore, this study attempted to develop an automated synthesizer for the routine clinical application of ⁶⁸Ga radiopharmaceuticals. The automated synthesizer was based on a fixed tubing system and the structure was designed after adjusting the position of the parts to reflect the synthesis method. Using various components that can be supplied in Korea, the automated synthesizer was manufactured at a much lower price cost than that of a commercialized automated synthesizer sold by companies. ⁶⁸Ga-DOTA-[Tyr3]-octreotide (⁶⁸Ga-DOTATOC) was synthesized to evaluate the performance of the automated synthesizer. ⁶⁸Ga-DOTATOC could be synthesized with about 65% of non-decay corrected yield, and the synthesized ⁶⁸Ga-DOTATOC met all quality control standards. We have synthesized ⁶⁸Ga-DOTATOC more than 100 times, and only faced a few problems caused by mechanical errors. In this study, we successfully developed a simple automated synthesizer for ⁶⁸Ga radiopharmaceuticals with high reproducibility. As various ⁶⁸Ga radiopharmaceuticals have recently been developed, it is expected that the automated synthesizer developed in this study will be useful for routine clinical use.

• Korean Journal of Clinical Laboratory Science
• /
• v.55 no.4
• /
• pp.261-268
• /
• 2023

[¹⁸F]Fluorocholine is a radiopharmaceutical used non-invasively in positron emission tomography to diagnose parathyroid adenoma, prostate cancer, and hepatocellular carcinoma by evaluating the choline metabolism. In this study, a radiolabeling method for [¹⁸F]fluorocholine was optimized using a solid phase extraction (SPE) cartridge. [¹⁸F]Fluorocholine was labeled in two steps using an automated synthesizer. In the first step, dibromomethane was reacted with [¹⁸F]KF/K2.2.2/K₂CO₃ to obtain the intermediate [¹⁸F]fluorobromomethane. In the second step, [¹⁸F]fluorobromomethane was passed through a Sep-Pak^Ⓡ Silica SPE cartridge to remove the impurities and then reacted with N,N-dimethylaminoethanol (DMAE) in a Sep-Pak^Ⓡ C18 SPE cartridge to label [¹⁸F]fluorocholine. The reaction conditions of [¹⁸F]fluorocholine were optimized. The synthesis yield was confirmed according to the number of silica cartridges and DMAE concentration. No statistically significant difference in the synthesis yield of [¹⁸F]fluorocholine was observed when using four or three silica cartridges (P>0.05). The labeling yield was 11.5±0.5% (N=4) when DMAE was used as its original solution. On the other hand, when diluted to 10% with dimethyl sulfoxide, the radiochemical yield increased significantly to 30.1±5.2% (N=20). In conclusion, [¹⁸F]Fluorocholine for clinical use can be synthesized stably in high yield by applying an optimized synthesis method.