• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.102-109
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• 2009

Purpose: Flash 3D (pixon(R) method; 3D OSEM) was developed as a software program to shorten exam time and improve image quality through reconstruction, it is an image processing method that usefully be applied to nuclear medicine tomography. If perfoming brain diamox perfusion scan by reconstructing subtracted images by Flash 3D with shortened image acquisition time, there was a problem that SNR of subtracted image is lower than basal image. To increase SNR of subtracted image, we use LEAP collimators, and we emphasized on sensitivity of vessel dilatation than resolution of brain vessel. In this study, our purpose is to confirm possibility of application of LEAP collimators at brain diamox perfusion tomography, identify proper reconstruction factors by using Flash 3D. Materials and methods: (1) The evaluation of phantom: We used Hoffman 3D Brain Phantom with $^{99m}Tc$. We obtained images by LEAP and LEHR collimators (diamox image) and after 6 hours (the half life of $^{99m}Tc$: 6 hours), we use obtained second image (basal image) by same method. Also, we acquired SNR and ratio of white matters/gray matters of each basal image and subtracted image. (2) The evaluation of patient's image: We quantitatively analyzed patients who were examined by LEAP collimators then was classified as a normal group and who were examined by LEHR collimators then was classified as a normal group from 2008. 05 to 2009. 01. We evaluate the results from phantom by substituting factors. We used one-day protocol and injected $^{99m}Tc$-ECD 925 MBq at both basal image acquisition and diamox image acquisition. Results: (1) The evaluation of phantom: After measuring counts from each detector, at basal image 41~46 kcount, stress image 79~90 kcount, subtraction image 40~47 kcount were detected. LEAP was about 102~113 kcount at basal image, 188~210 kcount at stress image and 94~103 at subtraction image kcount were detected. The SNR of LEHR subtraction image was decreased than LEHR basal image about 37%, the SNR of LEAP subtraction image was decreased than LEAP basal image about 17%. The ratio of gray matter versus white matter is 2.2:1 at LEHR basal image and 1.9:1 at subtraction, and at LEAP basal image was 2.4:1 and subtraction image was 2:1. (2) The evaluation of patient's image: the counts acquired by LEHR collimators are about 40~60 kcounts at basal image, and 80~100 kcount at stress image. It was proper to set FWHM as 7 mm at basal and stress image and 11mm at subtraction image. LEAP was about 80~100 kcount at basal image and 180~200 kcount at stress image. LEAP images could reduce blurring by setting FWHM as 5 mm at basal and stress images and 7 mm at subtraction image. At basal and stress image, LEHR image was superior than LEAP image. But in case of subtraction image like a phantom experiment, it showed rough image because SNR of LEHR image was decreased. On the other hand, in case of subtraction LEAP image was better than LEHR image in SNR and sensitivity. In all LEHR and LEAP collimator images, proper subset and iteration frequency was 8 times. Conclusions: We could archive more clear and high SNR subtraction image by using proper filter with LEAP collimator. In case of applying one day protocol and reconstructing by Flash 3D, we could consider application of LEAP collimator to acquire better subtraction image.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.1
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• pp.17-29
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• 2015

Purpose For nuclear medicine technologists, it is difficult to stay away from or to separate from radiation sources comparing with workers who are using radiation generating devices. Nuclear medicine technologists work is recognized as an optimized way when they are familiar with work practices. The aims of this study are to measure radiation exposure of technologists working in PET and to evaluate the occupational radiation dose after implementation of strategies to lower exposure. Materials and Methods We divided into four working types by QC for PET, injection, scan and etc. in PET scan procedure. In QC of PET, we compared the radiation exposure controlling next to $^{68}Ge$ cylinder phantom directly to controlling the table in console room remotely. In injection, we compared the radiation exposure guiding patient in waiting room before injection to after injection. In scan procedure of PET, we compared the radiation exposure moving the table using the control button located next to the patient to moving the table using the control button located in the far distance. PERSONAL ELECTRONIC DOSEMETER (PED), Tracerco$^{TM}$ was used for measuring exposed radiation doses. Results The average doses of exposed radiation were $0.27{\pm}0.04{\mu}Sv$ when controlling the table directly and $0.13{\pm}0.14{\mu}Sv$ when controlling the table remotely while performing QC. The average doses of exposed radiation were $0.97{\pm}0.36{\mu}Sv$ when guiding patient after injection and $0.62{\pm}0.17{\mu}Sv$ when guiding patient before injection. The average doses of exposed radiation were $1.33{\pm}0.54{\mu}Sv$ when using the control button located next to the patient and $0.94{\pm}0.50{\mu}Sv$ when using the control button located in far distance while acquiring image. As a result, there were statistically significant differences(P<0.05). Conclusion: From this study, we found that how much radiation doses technologists are exposed on average at each step of PET procedure while working in PET center and how we can reduce the occupational radiation dose after implementation of strategies to lower exposure. And if we make effort to seek any other methods to reduce technologist occupational radiation, we can minimize and optimize exposed radiation doses in department of nuclear medicine. Conclusion From this study, we found that how much radiation doses technologists are exposed on average at each step of PET procedure while working in PET center and how we can reduce the occupational radiation dose after implementation of strategies to lower exposure. And if we make effort to seek any other methods to reduce technologist occupational radiation, we can minimize and optimize exposed radiation doses in department of nuclear medicine.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.76-79
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• 2012

Purpose: This study was to evaluate usefulness of $^{99m}Tc$-MIBI scintimammography for dense breast by comparing concordance in test results between Tc-99m MIBI scintimammography and mammography whose effect was proved the most as an imaging tool depending on breast density and at the same time by examining limitation on evaluation depending on density of breast tissue. [Materials and Methods] In the period from December 2010 to July 2011, this study targeted 150 patients who took both of $^{99m}Tc$-MIBI scintimammography and mammography conducted by using breast gamma camera in this hospital. Breast density was classified to the four levels of pattern 1~4 based on the results of mammography. $^{99m}Tc$-MIBI scintimammography was conducted with the LCC, the RCC, the LMLO, and the RML one minute after intravenous injection of 99mTc-MIBI 7400 MBq (20 mCi) while analysis was made for concordance in test results of $^{99m}Tc$-MIBI scintimammography and mammography. [Results] Among the 150 patients, pattern 1 was found in 3 patients, pattern 2 in 44 patients, pattern 3 in 61 patients, and pattern 4 in 37 patients. There were 5 patients who showed the case where it was impossible to determine density of breast tissue due to foreign body inserted to breast. The concordance ratio of the results between $^{99m}Tc$-MIBI scintimammography and mammography was 95.5% for pattern 2, 95.1% for pattern 3 and 94.6% for pattern 4. This demonstrated that the concordance rate decreased according to the increase in breast density. [Conclusion] When there was limitation on evaluation of breast specific gamma imaging test results due to increased intake in breast tissue or surgical site, the concordance rate was 6.8% for pattern 2, 16.3% for pattern 3 and 18.9% for pattern 4. This demonstrated that the degree of limitation on evaluation of breast specific gamma imaging test results increased according to the increase in breast density.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.69-74
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• 2016

Purpose Using a regression formula of the trendline near the coefficient of determination (R2) "1" by substituting the dependent variable of the standard curve to calculate the values of the independent variable. To determine the suitability of a regression equation by comparing the difference between the independent variables of the standard curve and the predicted independent variables. Materials and Methods Perkin Elmer Gamma-Counter machine was used for Standard curve of regression methods. TSH. TG-Ag (Thyroglobulin Antigen), Insulin that used materials and method test to compare the result from the Excel trendline of the regression formula. Results Each of the value of coefficient of determination ($R^2$) and Trendline $R^2=1$, Polynomial Trendline for TSH, $R^2=1$, Polynomial Trendline for TG-Ag, $R^2=0.9994$, Polynomial Trendline for Insulin. Conclusion We confirmed that IRMA immune method is found to the nearest trends elected a standard curve using polynomial trendline. The independent variables to predict the trend by using a polynomial trendline formula containing the error was a limitation.

• The Korean Journal of Nuclear Medicine
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• v.26 no.1
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• pp.127-132
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• 1992

Colloidal $^{32}P$ chromic phosphate is used to prevent hepatic metastasis from colorectal cancer. It is speculated that the intravenous injection of colloidal $^{32}P$ chromic phosphate can cause genotoxicity. To evaluate the genotoxicity of intravenously injected colloidal $^{32}P$ chromic phosphate, authors performed a micronuclei test in mice bone marrow. Mice (ICR strain, $25\sim30g$) were divided to 4 groups: control, group 1 (19.166 KBq/g, usual therapeutic dose in human), group 2 (191.66 KBq/g), and group 3 (1916.6 KBq/g). Five mice of each group were sacrificed at days 1, 2, 3, 5, 7 and 14. Bone marrow were smeared and stained with Wright-Giemsa method. One thousand polychromatic erythrocytes (PCE) and normochromatic erythrocytes (NCE) were counted under the light microscope, and the number of micronucleated PCEs and NCEs were recorded. The frequency of micronuclei in PCE and NCE in the control group was $0.3{\pm}0.06%\;and\;0.45{\pm}0.10%$, respectively. At group 1, frequency of micronuclei is not different from the control. However, frequencies of micronuclei in PCE at groups 2 and 3 were significantly increased from day 1 and persisted to day 14. The frequency of micronuclei in NCE was increased only at group 3. In conclusion, the frequency of micronuclei increases as the dose of colloidal $^{32}P$chromic phosphate increases, while micronuclei was not induced at the usual therapeutic dose. And the frequency of micronuclei persistently elevated for 14 days in the cases of higer doses.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.60-73
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• 2014

Objectives: This study aims at decreasing spatial dose rate through work improvement whilst spatial dose rate is the cause of increasing personal exposure dose which occurs in the process of handling radioisotope. Methods: From February 2013 until July 2013, divided into "before" and "after" the improvement, spatial dose rate in laboratory of nuclear medicine was measured in gamma image room, PET/CT-1 image room, and PET/CT-2 image room as its locations. The measurement time was 08:00, 12:00 and 17:00, and SPSS 21.0 USA was opted for its statistical analysis. Result: The spatial dose rate at distribution worktable, injection table, the entrance to the distribution room, and radioisotope storage box, which had showed high spatial dose rate, decreased by more than 43.7% a monthly average. The distribution worktable, that had showed the highest spatial dose rate in PET/CT-1 image room, dropped the rate to 42.3% as of July. The injection table and distribution worktable in the PET/CT-2 image room also showed the decline of spatial dose rate to 89% and 64.4%, respectively. Conclusion: By improving distribution process and introducing proper radiation shielding material, we were able to drop the spatial dose rate substantially at distribution worktable, injection table, and nuclide storage box. However, taking into account of steadily increasing amount of radioisotope used, strengthening radiation related regulations, and safe utilization of radioisotope, the process of system improvement needs to be maintained through continuous monitoring.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.1
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• pp.15-19
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• 2009

Purpose: The aim of study is to find a correlation between Salivary clearance rate using saliva and blood and Secretion rate and Excretion rate using Salivary gland Scan images. Materials and Methods: Salivary Scan and Stimulate clearance of $^{99m}Tc$-pertechnate was performed in 20 patients with moderate function(group 1), 9 patients with severe function glands (group 2), 3 patients with non function (group 3) and normal 6 controls. Salivay clearance rate was compare with Secretion rate and Excretion rate of Salivary glands' ROI. Result: Stimulate salivary clearance of normal controls was 18.4 ml/min, salivary clearance of group 1 was 10.1 ml/min, salivary clearance of group 2 was 10.4 ml/min and salivary clearance of group 3 was 2.3 ml/min. Significant difference was found between normal controls and group 2,3 (p<0.05, p<0.05). Secretion rate and Excretion rate of normal controls was 21.6%, 24.6%, Secretion rate and Excretion rate of group 1 was 17.6%, 24.0%, Secretion rate and Excretion rate of group 2 was 8.8%, 13.9% and Secretion rate and Excretion rate of group 3 was 5.6%, 2.9%. Significant difference was found between normal controls and group 2,3 (p<0.05, p<0.05). Conclusions: Stimulate salivary clearance using saliva and blood and Secretion rate and Excretion rate using Salivary gland Scan images accord well together.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.1
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• pp.27-32
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• 2008

Purpose: The evaluation of SUV (Standardized Uptake Values) for quantitative analysis in PET exam is the most significant. In PET exam, we make attenuation correction images by using $^{68}Ge$, $^{137}Cs$ or CT data. At this time, a distorted attenuation map affects quantitative analysis. After the exam using barium-sulfate and high density of barium contrast make attenuation map distorted. And then it brings bed influences on SUV. The aim of this study is to verify the relationship between high density barium-sulfate and SUV in PET exam. Materials and Methods By using $^{18}F$-FDG, we made barium-sulfate powder, density of 0, 1.5, 3, 5, 10 and 15% respectively and acquired PET and PET/CT images per each density. And we examined SUV variations from PET and PET/CT images according to differences of barium's density. Moreover, we finally calculated SUV causing variations in HU (Hounsfield Units) values to justify whether the differences of barium density bring any changes in PET/CT exam. Results: From PET images acquired from transmission scan with $^{68}Ge$, we got SUV figures from 6.46 to 6.8 in barium density between 0 to 15 percent. On the other hand, In PET images acquired from Tx scan that using CT, SUV was 6.77 to 23.73, derived from the same barium density. And CT HU values range from 29 to 2004. Conclusion: PET images from Tx data using $^{68}Ge$ weren't affected by barium density and had no differences in SUV. But in the PET/CT images using CT Tx data, there's considerable variations in HU and SUV values according to a difference of barium density in HU values. To perform a precise examination, barium sulfate should be removed from a human body before performing a PET exam.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.145-148
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• 2014

Purpose: Serum thyroglobulin (Tg) determination has been reported to be a sensitive indicator of persistent or recurrent differentiated thyroid cancer (DTC) after total thyroidetectomy. In patients free of metastasese and recurrences after a complete thyroidectomy and radioiodine removal for DTC, the Tg is usually <1 ng/mL or can no longer be detected even with TSH stimulation. Therefore, report in low Tg levels and selecting criteria for retest is very important. The purpose of this study was to establish selecting criteria for retest which is efficient at reliability improvement and Turn around time (TAT). Materials and Methods: Sera from 137 patients with DTC were divided into two groups as first(<1.0 ng/mL or >4.0 ng/mL) and second(1.0-4.0 ng/mL). In case of group(<1.0 ng/mL) is in patient free of metastases and recurrences, >4.0 ng/ml is low coefficient of variation (CV%) at internal quality control and good linearity at standard curve. Therefore first group began with Delta/Panic check (D/P) and second group surveyed with the latest results. In that the latest results were <1.0 ng/ml, we checked the thyroxin withdrawal. Finally selected specimen retested with raw specimen. Results: In first group, we was able to reduce the retest rate(30.8% to 7.7%). and In second group, 40% to 5%. The total retest rate was 7.3%. Conclusion: If using the selecting criteria for retest, is helpful to accuracy and quickness of the result report.

• Journal of the Korean Society of Safety
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• v.24 no.6
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• pp.157-162
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• 2009

Radioactive medicines are used a lot owing to the increase of a PET-CT examination using glucose metabolism useful for the early diagnosis of diseases. Therefore, the spatial dose that is generated from patients and their surroundings causes the patients' guardians and health professional to be exposed to radiation. However, they get unnecessarily exposed to radiation because medical institutions lack in space for isolation and recognition of the examination. This research intended to examine the spatial dose rates by measuring the dose emitted from the patient for 48 hours to whom F-18 FDG was administered. The spatial dose rates that were measured 100cm away from the patient's body after F-18 FDG was injected were $65.88{\mu}$Sv/hr at 60-minute point, $45.13{\mu}$Sv/hr at 90-minute point, $9.88{\mu}$Sv/hr at 6-hour point, and $1.24{\mu}$Sv/hr at 12-hour point. When the dose that the guardian and health professional got was converted into the annual(240-day working) accumulative dose, it was examined that the guardian received 81.56 mSv/yr and health professional received 49.36mSv/yr. In addition, the result has revealed that the dose that the patient received from one time of PET-CT examination was 3.75mSv/yr, which is 1.5 times more when compared with the annual natural radiation exposure dose.