• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.152-155
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• 2009

Purpose: The most widely accepted tool for follow up management of thyroid cancer patients is serum thyroglobulin (Tg) measurement, but its value is limited by the interference of anti-thyroglobulin antibodies (anti-Tg Ab). Recently thyroglobulin measurement in the wash out of fine-needle aspiration biopsy specimens (Tg-FNAB) is frequently used for differential diagnosis of recurrences/metastases. The aim of this study was the investigation of the diagnostic utility of Tg-FNAB compared with serum Tg. Materials and Methods: We enrolled 41 consecutive patients with thyroid cancer who were evaluated for Tg-FNAB between January 2007 and February 2008 retrospectively. We ruled out 6 patients who anti-Tg Ab positive (${\geq}$100 U/mL) in the RIA (BRAHMS anti-Tgn RIA 100Det; BRAHMS Aktiengesell schaft, Berlin, Germany). Serum Tg and Tg-FNAB were measured by immunoradiometric assay (BRAHMS Tg pluS RIA 100 Det; BRAHMS Aktienge sellschaft, Berlin, Germany). We evaluated for Tg-FNAB compared with serum Tg and corresponding cytological smear. To compare the values of the two the t-test was used. Results: Tg-FNAB values were significantly higher (median 1,060 ng/mL, range 0.2~434,000 ng/mL) than serum Tg (median 2.5 ng/mL, range 0.9~131 ng/mL) (p=0.0394). The rate of correspondence with Tg-FNAB between cytological result was 87.9% and 65.9% in the case of serum Tg. Tg-FNAB was positive in 28 (24 with positive and 4 with suspicious cytology). Of the remaining 13 patients with negative Tg-FNAB, 1 had suspicious and 12 had unsuspicious cytology. serum Tg was positive in 26 (17 with positive and 3 with suspicious and 6 with unsuspicious cytology), Of the remaining 15 patients with negative serum Tg, 8 was positive in cytological result and 1 had suspicious and 6 had unsuspicious cytology. Conclusions: Tg-FNAB measurement is more accurate with high sensitivity (87.9%) than serum Tg (65.9%). The Tg-FNAB was a useful predictor for detecting recurrences/metastases with serum Tg.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.1
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• pp.47-51
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• 2016

Purpose By ingestion of 18F-FDG of kidney of PET/CT during the inspection, if additional examination is required, depending on whether you want to water intake, we want to confirm a change in the rate of decrease of F-18 FDG of the kidney. Materials and Methods The 80 patients without kidney disease were performed PET/CT examination. Device was analyzed after setting the kidney to a three-dimensional region of interest. In patients require additional examination, and inspection after 30 minutes, a PET/CT torso examination after the water of the 500 cc ingested at a time. After the addition of both water intake group and no hydration group of kidney of SUV, it was compared with PET/CT torso scan. Results High and low of the kidney SUV did not show a significant difference in the rate of decrease. Reduction rates of background (BKG) of additional examination was 2.8% and reduction rates of SUV was 49.7% (Hydration) : -6.8% (No hydration), so did show a significant difference. In the image blind test, the average point score of hydration and no hydration was 34.25 : 17.25. Conclusion An undercurrent of 18F-FDG in the kidney at the time of torso examination, it was confirmed that the reduction rate after the addition of water intake is high. It is considered that can be expected to improve the quality of an image due to a decrease in elongation through the kidneys examination with additional fluid intake as needed intake.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.113-116
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• 2011

Purpose: Acetylcholine receptor antibodies cause acetylcholine receptor loss, which is responsible for failure of the neuromuscular junction in the acetylcholine receptor autoantibody. The disease characterized by muscle weakness and fatigue, myasthenia gravis(MG) occurs when the body inappropriately produces antibodies against acetylcholine receptors, and thus inhibits proper acetylcholine signal transmission. And this reason, the measurement of acetylcholine receptor antibodies can be of considerable value in disease diagnosis. Methods: From 2010. August to September, we tested orderd AchRAb 19 samples to get the results. 1. Pipette $5{\mu}{\ell}$ undiluted patient sera and kit control and add 125I AChR $50{\mu}{\ell}$ and incubate at R.T for 2 hours. 2. Pipette $50{\mu}{\ell}$ of anti-human IgG into each tube, and incubate at $2{\sim}8^{\circ}C$ for 2 hours. 3. Pipette $25{\mu}{\ell}$ precipitation enhancer into each tube and add 1mL washing solution into all tubes. 4. Centrifuge each tube for 20minutes at $2{\sim}8^{\circ}C$ at 1500g. 5. Aspirate or decant the supernatant. 6. Pipette 1 mL washing solution into all tubes and resuspend the pellet and repeat centrifugation. 7. Aspirate or decant the supernatant and count all tubes on a gamma counter. Results: Cut off value is 0.2 nmol/L and the results taken below 0.2 nmol/L are negative, the results above that identified as being positive values. We assayed the 19 patients samples and got 7 positive results. Of which, 6 patients were diagnosed as MG.(85.7%). Conclusions: Acetylcholine Receptor autoantibody test is intended for use by persons only for the quantitative determination of it in human serum. Even if measurement of the antibodies is not a routine test, it can be of considerable value in disease diagnosis.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.3
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• pp.229-234
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• 2008

Hepatobiliary scintigraphy is very sensitivity of hepatic cell and gallbladder, biliary track atresia and biliary leakage. however, Hepatobiliary scan of biliary leakage diagnosis was separated determine biliary leakage and bowl drainage bile-juice. The object of this study will determine biliary leakage and bowl drainage bile-juice to hepatobiliary scintigraphy both decubitus position in bile leakage patients. Material & Methode: 31 patients (meal 14, Femeal 17), $51.1{\pm}14.4$ years. dynamic scan acquisition 60 farme for 60 minute on supine position. and delay scan was 2 hrs, 4 hrs, 24 hrs for 5 minute on supine, both decubitus position. Both decubitus position scan was kept for 5 minutes. Efficient of Hepatobiliary Scintigraphy both decubitus position in bile leakage patients was compared leakage size, density, image of supine position and both decubitus position. Results: 23 patients for 31 bile leakage patients was checked up function image or delay image, and 8 patients was checked up bile leakage on both decubitus. anatomical leakage location was supine position very well, but both decubitus position was separated bile leakage and moving bile-juice in bowl. also, uptake (counts/pixel) average of roi and bkg was supine 5.02, left decubitus 2.08, right decubitus 2.68. No. pixels of supine ROI counted 1.91 times than left decubitus, 1.05 times than right decubitus. Conclusion: 31 patient both decubitus position, but decubitus position was separated bile juice movement in bowl leakage location. also, It was compared ROI/BKG ratio and ROI No. pixels of supine, both decubitus in 38.5% patients. And No. pixels of supine position was large 19%, 5% than left decubitus, right decubitus, And density was in low 60%, 50% than left decubitus, right decubitus. It was mean bile leakage of ROI. so, If Hepatobiliary Scintigraphy was additional both decubitus position scan in bile leakage patients, this study will be more valuable in diagnosis of bile leakage.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.29-34
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• 2019

Purpose An examination guide is a useful medium to provide the patient with an overview, pre- and post-test preparation, and precautions of nuclear testing. The design and arrangement of existing written texts and announcements were evaluated to elucidate the comprehension of patients undergoing testing. Materials and Methods Informational material describing bone scanning and $^{201}thallium$ myocardium perfusion single-photon emission computed tomography (SPECT), as a secondary examination, which accounts for the largest portion of gamma imaging at Asan Hospital (Seoul, South Korea), was selected as an improvement target in consultation with a national innovation center. Existing informational material was dispensed to patients scheduled for bone scans from November 2016 to February 2017 and the revised material was issued from March 2017 to May 2017. A survey was conducted of 200 patients who underwent $^{201}thallium$ myocardium perfusion SPECT before and after the revisions (n = 100 each time period) to assess the patients' understanding of the informational material. Results When comparing the use of the conventional vs. revised material, the number of patients who received treatment before bone scanning had decreased from 130 to 60, while the number of those who required additional imaging decreased from 53 to 14. Prior to the revision, 43% of patients underwent testing before preparation and 18% underwent additional testing. The decreased need for additional image acquisition after revision of the informational material resulted in a decrease in acquisition time of about 2 min, from 16.5 to 14.2 min. In the case of $^{201}thallium$ myocardium perfusion SPECT, patient comprehension of all five items surveyed had increased, while the number of patients who had repeatedly asked about various facets of the procedure pre- and post-testing had decreased from 36% to 16% and 31% to 14%, respectively. Conclusion Lower patient comprehension is accompanied by a decrease in image quality due to non-compliance during pre-testing and may lead to repetitive questions from the patient, which may also negatively affect the fatigue and work efficiency of the examiner. Improved readability and visibility of informational material through visualization was correlated with greater patient comprehension as well as improved image quality and acquisition time.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.2
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• pp.88-91
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• 2018

Purpose The purpose of this study is to investigate the simultaneous dual isotope (SDI) myocardial perfusion scan that can be performed in a short time using a semiconductor gamma camera. Materials and Methods Of the 86 patients who underwent Rest/Stress $^{99m}TC$-sestaMIBI 1-day myocardial perfusion scan and Rest $^{99m}TC$-sestaMIBI/Stress $^{201}Tl$ simultaneous dual isotope myocardial perfusion scan using a heart-only gamma camera, the test results were the same, 36 patients who did not show any change in the clinical outcome. Quantitative values were statistically analyzed using a QPS program to confirm the correlation between the images of the two examinations. Results Rest/Stress $^{99m}TC$-sestaMIBI simultaneous dual myocardial perfusion scans and $^{99m}TC$-sestaMIBI/Stress $^{201}Tl$ double-isotope myocardial perfusion scans were analyzed for Summed score. The $R^2$ value of the Rest summed score (RSS) was 0.91 and the $R^2$ value of the stress summed score (SSS) was 0.71. Conclusion The $^{99m}TC$-sestaMIBI/Stress $^{201}Tl$ simultaneous dual isotope scan confirmed its correlation with the previous day's test. The $^{99m}TC$-sestaMIBI/Stress $^{201}Tl$ simultaneous dual isotope scan can be completed in approximately 30minutes. It maybe clinically useful for patients who need short examination time such as emergency patients or elderly patients.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.2
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• pp.97-100
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• 2018

Purpose The glomerular filtration rate (GFR) test is an important indicator of glomerular filtration and has been used to test renal function and the extent of its function. The GFR test is performed by intravenous injection of radioactive medicines made of $^{51}Cr$-EDTA, and blood concentration is measured by taking blood according to the elapsed time. also, PET-CT, bone scan, transfusion and so on will affect the outcome. Therefore, we will improve the quality of the test by providing guidelines for the GFR test for more accurate testing. Materials and Methods 5 mL of physiological saline solution and 2 mL of $^{51}Cr$-EDTA solution are used to make 5 mL of the radiopharmaceutical solution to be injected into the patient. First, the syringe weight is measured before the injection, and then the radioactive medicine is injected into the patient's vein and the syringe weight is measured after the injection. Blood sampling is performed twice in total. In adults, blood is collected 3 hours / 5 hours after injection and in children 2 hours / 5 hours after injection. The blood sample is centrifuged at 3300 rpm for 5 minutes. Standard solution is prepared by filling diluent water up to the scale indicated in the 200-mL volumetric flask, discarding $500{\mu}L$, injecting $500{\mu}L$ of GFR reagent and mixing well. $500{\mu}L$ each of the standard solution is dispensed into two test tubes, and $500{\mu}L$ of each of the plasma samples collected in time is dispensed into two test tubes and measured with a Cobra Counter. Results At present, the reference range applied in this study is $119.5{\pm}30.3ml/min/1.73m2$ for males and $125.2{\pm}28.2ml/min/1.73m^2$ for females. Conclusion The GFR test is conducted using radioactive medical products. GFR testing is performed as a scheduled test, but PET-CT, dialysis and transfusion, which may affect GFR testing, may be scheduled during GFR testing. Therefore, we could get accurate GFR test results by notifying the ward and department beforehand when booking.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.115-118
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• 2012

Purpose: The Levey-Jennings chart controlled measurement values that deviated from the tolerance value (mean ${\pm}2SD$ or ${\pm}3SD$). On the other hand, the upgraded Westgard Multi-Rules are actively recommended as a more efficient, specialized form of hospital certification in relation to Internal Quality Control. To apply Westgard Multi-Rules in quality control, credible quality control substance and target value are required. However, as physical examinations commonly use quality control substances provided within the test kit, there are many difficulties presented in the calculation of target value in relation to frequent changes in concentration value and insufficient credibility of quality control substance. This study attempts to improve the professionalism and credibility of quality control by applying Westgard Multi-Rules and calculating credible target value by using a commercialized quality control substance. Materials and Methods : This study used Immunoassay Plus Control Level 1, 2, 3 of Company B as the quality control substance of Total T3, which is the thyroid test implemented at the relevant hospital. Target value was established as the mean value of 295 cases collected for 1 month, excluding values that deviated from ${\pm}2SD$. The hospital quality control calculation program was used to enter target value. 12s, 22s, 13s, 2 of 32s, R4s, 41s, $10\bar{x}$, 7T of Westgard Multi-Rules were applied in the Total T3 experiment, which was conducted 194 times for 20 days in August. Based on the applied rules, this study classified data into random error and systemic error for analysis. Results: Quality control substances 1, 2, and 3 were each established as 84.2 ng/$dl$, 156.7 ng/$dl$, 242.4 ng/$dl$ for target values of Total T3, with the standard deviation established as 11.22 ng/$dl$, 14.52 ng/$dl$, 14.52 ng/$dl$ respectively. According to error type analysis achieved after applying Westgard Multi-Rules based on established target values, the following results were obtained for Random error, 12s was analyzed 48 times, 13s was analyzed 13 times, R4s was analyzed 6 times, for Systemic error, 22s was analyzed 10 times, 41s was analyzed 11 times, 2 of 32s was analyzed 17 times, $10\bar{x}$ was analyzed 10 times, and 7T was not applied. For uncontrollable Random error types, the entire experimental process was rechecked and greater emphasis was placed on re-testing. For controllable Systemic error types, this study searched the cause of error, recorded the relevant cause in the action form and reported the information to the Internal Quality Control committee if necessary. Conclusions : This study applied Westgard Multi-Rules by using commercialized substance as quality control substance and establishing target values. In result, precise analysis of Random error and Systemic error was achieved through the analysis of 12s, 22s, 13s, 2 of 32s, R4s, 41s, $10\bar{x}$, 7T rules. Furthermore, ideal quality control was achieved through analysis conducted on all data presented within the range of ${\pm}3SD$. In this regard, it can be said that the quality control method formed based on the systematic application of Westgard Multi-Rules is more effective than the Levey-Jennings chart and can maximize error detection.

• The Korean Journal of Nuclear Medicine
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• v.27 no.1
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• pp.35-50
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• 1993

심근관류 스캔에서 약제부하 검사에 많이 이용되는 것으로는 adenosine, dipyridamole, dobutamine등이 있다. 이 약제들이 혈역학 및 thallium의 약동학에 미치는 효과를 검사하기 위하여 저자들은 15명의 건강인을 대상으로 이들 약제를 정맥주사한 후에와 그리고 운동부하를 시행한 후에 thallium-201 신근관류 스캔을 시행하여 thallium의 약동학에 미치는 영향에 대하여 서로 비교하였다. 부작용은 adenosine (87%), dipyridamole(80%), dobutamine (73%)을 정맥주사할 시에 흔히 나타났으나 경미하였다. 1예에서는 dobutamine을 주사할때의 부작용으로 인하여 최대용량을 투여하지는 못한바 있었다. 대상들은 dipyridamole (13%)이나 dobutamine (27%)보다 adenosine (60%)을 선호하였다 (P<0.05). Thallium의 절대 적인 심근섭취는 운동부하 검사보다 adenosine (1.3배), dipyridamole(1.2배), dobutamine(1.4배) 부하시에 더 많았고, 이들 약제 사이에는 유의한 차이는 없었다. Thallium의 심근제거율(%/hr)는 운동부하 검사보다 약제부하한 후에가 더 늦었다. 폐, 간, 비장, 및 내장지역에서 thallium의 섭취 및 제거는 운동부하 검사보다 약제부하시에 더 많았으나, 이들 약제 사이에는 유의한 차이가 없었다. Dobutamine 투여시의 thallium의 섭취 및 제거는 adenosine 또는 dipyridamole을 투여시의 결과와 상응하였다. 저자들은 adenosine, dipyridamole 및 dobutamine을 이용한 약제부하 thallium-201 심근관류 검사를 시행하는데 코든 대상들에서 어려움 없이 쉽게 시행할 수 있었다. Thallium의 심근내 섭취 및 제거는 각 약제부하에 따라서 다를 수가 있으므로 심근관류 스캔의 정량적인 분석을 시행할 때는 각각 약제에 대한 특별한 진단기준이 마련되어야 할 것으로 생각된다.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.83-86
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• 2010

Purpose: The Molybdenum which is the raw material of $^{99}Mo$-$^{99m}Tc$ generator (generator) is produced from the nuclear reactor. However, output has dwindled as the two nuclear reactors supplying the bulk of radioactive material-one in Chalk River, Ontario and the other in Petten, the Netherlands-have been closed for repairs or maintenance. This resulted in the enhancement of its price. Therefore we have tried to seek the new method which could run generator to increase activity of $^{99m}Tc$ in this study. Materials and Methods: The $^{99m}Tc$ activity obtained from 5 times elution for 5 days from Monday to Friday using two generators was compared with 10 times elution. Appearance test, pH test, LAL test, sterility test, chemical impurity(Al) test, radio chemical purity test, ratio of $^{99}Mo$/$^{99m}Tc$ activity test have been done to check the stability of $^{99m}Tc$ eluting from generator respectively. Results: The $^{99m}Tc$ activity obtained from 5 times elution for 5 days was 168.2 GBq (4545 mCi) and 10 times was 230.5 GBq (6230 mCi). All quality control tests were within normal limit. Conclusion: We got to know that 2 times elution a day obtained more $^{99m}Tc$ activity than one time elution in this study.