• Imaging Science in Dentistry
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• 제34권2호
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• pp.91-97
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• 2004

Purpose : This study was performed to evaluate the diagnostic value of both planar and SPECT imagings by comparing the results with the clinical and other imaging modalities findings. Materials and Methods: A total of 578 joints with TMJ complaints were examined using planar scintigraphy and SPECT. The planar scintigraphy and SPECT findings were analyzed and compared to the clinical findings of pain, clicking, crepitus and limitation of mouth opening. Moreover we compared the accuracy of the planar scintigraphy and SPECT methods with the one of the panoramic, transcranial, tomographic and MR imaging methods. Results: The planar scintigraphy and SPECT methods showed a high sensitivity of 0.76-0.84 and low specificity of 0.25-0.45 toward the clinical findings: pain, clicking, crepitus and mouth opening restriction. Simple radionuclide uptake ratio was high in each group of patients with pain, crepitus, limitation of mouth opening (p < 0.05) complaints, in each group with positive bone changes on panoramic, transcranial or tomographic images, and in disc displaced group. Conclusion: Although both planar and SPECT imagings have limited specificity, these techniques are sensitive for detection of internal derangement of the TMJ.

• Tuberculosis and Respiratory Diseases
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• 제48권6호
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• pp.870-878
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• 2000

목적 : 초진시 흉부 X-선 소견상 경증의 폐결핵 병변을 보이면서 활동성 미정으로 판독되었을 때, 객담 검사장 결핵균이 검출되지 않은 경우가 많아 그러한 환자군에서 결핵의 활동성 평가를 위한 $^{67}Ga$ 평면영상의 가치를 확인하고, 일반적으로 평면영상보다 민감도와 정확도가 높다고 알려진 SPECT과의 비교 분석을 통해 두 검사간의 유용성올 평가하고자 하였다. 대상 및 방법 : 1996년 6월부터 1999년 12월까지 본원 내과에 내원 한 환자 중 최초 흉부 X-선 소견상 경증의 폐결핵 병변을 보이면서 활동성 미정으로 판독된 69예를 대상으로 $^{67}Ga$ 평면영상과 SPECT를 동시에 시행하였다. 결과 : 전체 대상환자 69예 중 최종 활동성 폐결핵으로 판정된 37예 중 객담 결핵균 도말 검사에서 8예(22%), 객담 배양검사에서 8예(22%)가 균양성 이었으며，임상적으로 항결핵제를 투약하여 6개월 지나 추적 검사한 흉부 X-선에서 호전을 보인 경우가 21예 (57%)였다. 최종 활동성으로 판정된 37예 중 $^{67}Ga$ 평면영상에서 섭취 소견이 보인 경우는 24예(65%), 섭취소견이 보이지 않은 경우가 13예(35%)였으며, SPECT에서 섭취 소견이 보인 경우는 25예(68%), 섭취소견이 보이지 않은 경우가 12예(32%)였다(Table 2). 최종 비활동성 폐결핵으로 판정된 32예 중 $^{67}Ga$ 평면영상에서는 모든 예에서 섭취 소견이 보이지 않았고, SPECT에서 섭취 소견이 보이지 않은 경우가 31예(97%), 섭취 소견이 보인 경우가 1예(3%)였다. 결론 : X-선 소견상 경증의 폐결핵 병변을 보이면서 활동성 미정인 폐결핵 환자의 활동성 판정에 있어서 $^{67}Ga$ 평면영상은 민감도가 65%, 특이도가 100%, 음성 예측율이 71.1%이고, SPECT은 민감도가 68%, 특이도가 97%, 음성 예측율이 72.1%로 나타났다. 흉부 X-선 소견에서 초진시 활동성 미정으로 판독된 경증 폐결핵 환자에서 $^{67}Ga$ 평면영상과 SPECT은 초진시 활동성 여부 판정에 모두 유용한 것으로 사료되며 $^{67}Ga$ 평면영상과 SPECT의 비교분석에서 민감도와 특이도, 음성예측율에서도 통계학적으로 유의한 차이는 발견하지 못하였다.

• Korean Journal of Radiology
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• 제24권10호
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• pp.1017-1027
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• 2023

Objective: The assessment of cortical integrity following renal injuries with planar Tc-99m dimercaptosuccinic acid (DMSA) scintigraphy depends on measuring relatively decreased cortical uptake (i.e., split renal function [SRF]). We analyzed the additive values of the volumetric and quantitative analyses of the residual cortical integrity using single-photon emission computed tomography (SPECT) compared to the planar scintigraphy. Materials and Methods: This prospective study included 47 patients (male:female, 32:15; age, 47 ± 22 years) who had non-operatively managed renal injuries and underwent DMSA planar and SPECT imaging 3-6 months after the index injury. In addition to planar SRF, SPECT SRF, cortical volume, and absolute cortical uptake were measured for the injured kidney and both kidneys together. The correlations of planar SRF with SPECT SRF and those of SRF with volumetric/quantitative parameters obtained with SPECT were analyzed. The association of SPECT parameters with renal function, grades of renal injuries, and the risk of renal failure was also analyzed. Results: SPECT SRF was significantly lower than planar SRF, with particularly higher biases in severe renal injuries. Planar and SPECT SRF (dichotomized with a cutoff of 45%) showed 19%-36% of discrepancies with volumetric and quantitative DMSA indices (when dichotomized as either high or low). Absolute cortical uptake of the injured kidney best correlated with glomerular filtration rate (GFR) at follow-up (ρ = 0.687, P < 0.001) with significant stepwise decreases by GFR strata (90 and 60 mL/min/1.73 m²). Total renal cortical uptake was significantly lower in patients with moderate-to-high risk of renal failure than those with low risk. However, SRF did not reflect GFR decrease below 60 mL/min/1.73 m² or the risk of renal failure, regardless of planar or SPECT (count- or volume-based SRF) imaging. Conclusion: Quantitative measurements of renal cortical integrity assessed with DMSA SPECT can provide more clinically relevant and comprehensive information than planar imaging or SRF alone.

• 대한핵의학회지
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• 제29권4호
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• pp.526-532
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• 1995

두경부의 악성 종양의 진단에서 $^{99m}Tc$-(V)-DMSA 영상술은 비교적 높은 양성율을 보여 주었고 (Planar 65%, SPECT 90%), 원격 전이부위의 영상진단에도 도움이 되었다. 그러나 $^{99m}Tc$-(V)-DMSA는 두경부의 양성 병변에도 섭취가 될 수 있어, 판독 시 임상검사 및 다른 영상소견과의 비교검토가 필요할 것으로 판단된다.

• 대한핵의학회지
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• 제33권6호
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• pp.475-483
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• 1999

목적: 안구보충물로 사용된 hydroxyapatite 내로의 섬유혈관증식은 이물질 반응으로 인한 염증의 동반없이 의안의 운동성을 유지시키기 위한 운동성 나사못을 삽입하는데 중요한 역할을 한다. 안구보충물 삽입술 후에 섬유혈관증식의 정도를 알아보는데 Tc-99m MDP를 이용한 평면영상과 단면영상에서 정성적 평가와 정량적 평가의 비교분석을 함으로서 완전한 섬유혈관증식을 예측하는데 단면영상의 유용성을 알아보고자 하였다. 대상 및 방법: 안구 제거술후 hydroxyapatite를 이용하여 안구보충술을 시행받고 $197{\pm}81$일 후에 골신티그라피를 시행받은 17명의 환자(남:녀=12:5, 연령; $50.4{\pm}17.5$세)의 18예를 대상으로 하였다. 골신티그라피는 Tc-99m MDP 740 MBq를 정맥주사 후 4시간 경과뒤에 이중헤드 감마카메라(ECAM, Siemens, Germany)로 안면부 평면영상을 얻은 후 이어서 단면영상을 얻었다. 평면영상과 단면영상에서의 안구보충물의 방사능 섭취가 비교(nasal bridge)보다 약한 경우를 grade 1, 비슷한 경우를 grade 2, 강한 경우를 grade 3로 평가하였고, 정상안구에 대한 안구보충물의 섭취비를 정량적으로 구하여 운동성 나사못 삽입술 후 시행된 세극등 검사에서 염증반응의 동반 없이 완전한 섬유혈관증식을 보인 환자 군과 염증 반응의 동반과 함께 불완전한 섬유혈관증식을 보인 환자 군으로 나누어 비교 분석하였다. 결과: 평면영상에서 grade 1은 9예, grade 2가 1예, grade 3가 2예로 충분한 섬유혈관증식을 의미하는 grade 2와 3를 보인 경우가 9예 (50%) 이었으나 단면영상에서는 grade 1이 6예, grade 2가 4예, grade 3가 8예로 평면영상에 비하여 grade 2와 3를 보이는 경우가 12예(61%) 이었다. 정성적 평가에 의한 완전한 섬유혈관증식을 예측하는 데 있어서 평면영상은 예민도가 60% (9/15),특이도 100% (3/3), 양성예측률 100% (9/9), 음성예측률 33.3% (3/9), 정확도 66.7% (12/18) 이었고 단면영상은 예민도 80% (12/15), 특이도 100% (3/3), 양성예측률 100% (12/12), 음성예측률 50% (3/6), 정확도 83.3% (15/18) 이었다. 정량적으로 구한 안구보충물 내의 방사능 섭취비는 평면영상에서 grade 1은 $1.19{\pm}0.10$, grade 2는 $2.16{\pm}0.43$, grade 3는 $3.57{\pm}0.74$로 grade가 높을수록 정량적 섭취비가 유의하게 증가하였다(p<0.001). 단면영상에서 grade 1은 $3.06{\pm}1.22$, grade 2는 $3.71{\pm}0.83$, grade 3는 $12.49{\pm}4.31$로 grade가 높을수록 정량적 섭취비가 유의하게 증가하였다(p<0.001). 완전한 섬유혈관증식을 보인 환자 군과 불완전한 섬유혈관증식을 보인 환자군으로 나누어 정량적으로 측정한 방사능 섭취비를 비교시 평면영상에서는 $1.96{\pm}0.87$ 대 $1.17{\pm}0.08$로 유의한 차이를 보이지 않았으나 단면영상에서는 $8.44{\pm}5.45$ 대 $2.20{\pm}0.87$로 유의한 차이를 보였다 (p<0.05). 결론: 안구보충물 삽입 후 섬유혈관증식을 평가할 때 평면영상에 비하여 단면영상이 섬유혈관증식 정도를 평가하는데 보다 도움을 주었다.

• Korean Journal of Radiology
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• 제22권4호
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• pp.604-611
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• 2021

Objective: The aim of this pilot study was to investigate the potential of early-phase single-photon emission computed tomography (SPECT)/computed tomography (CT) using technetium-99m methyl diphosphonate (^99mTc-MDP) for diagnosing osteomyelitis (OM). Materials and Methods: Twenty-one patients with suspected OM were enrolled retrospectively. Three-phase bone scan (TPBS), early-phase SPECT/CT (immediately after blood pool planar imaging), and delayed-phase SPECT/CT (immediately after delayed planar imaging) were performed. The final diagnoses were established through surgery or clinical follow-up for over 6 months. We compared three diagnostic criteria based on (I) TPBS alone, (II) combined TPBS and delayed-phase SPECT/CT, and (III) early-phase SPECT/CT alone. Results: OM was diagnosed in 11 of 21 patients (nine surgically and two clinically). Of the 11 OM patients, criterion-I, criterion-II, and criterion-III were positive in six, seven, and 10 patients, respectively. Of the 10 non-OM patients, criterion-I, criterion-II, and criterion-III were negative in five, five, and seven patients, respectively. The sensitivity/specificity/accuracy of criterion-I, criterion-II, and criterion-III for diagnosing OM were 54.5%/50.0%/55.0%, 63.6%/50.0%/57.1%, and 90.9%/70.0%/87.5%, respectively. Conclusion: This pilot study demonstrated the potential of using the early-phase SPECT/CT to diagnose OM. Based on the results, prospective studies with a larger sample size should be conducted to confirm the efficacy of early-phase SPECT/CT.

• 대한핵의학회지
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• 제25권1호
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• pp.61-67
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• 1991

The usefulness of $^{99m}Tc-labeled$ RBC single photon emission CT (SPECT) scanning in the diagnosis of hepatic heminagiomas was evaluated in 22 patients with various focal hepatic lesions including 15 cases of hemangiomas, 3 cases each of hepatomas and metastasis and 1 case of abscess. The diagnoses were based on ultrasonography and/or CT scanning, clinical stability of lesion for at least 6 months or surgical exploration. Seven cases of 15 hemangiomas were detected by delayed planar RBC scanning, whereas 4 cases were detected by delayed RBC-SPECT scanning. The smallest hemangioma shown by delayed RBC-SPECT scanning was 1.0 cm in diameter. compared with 2.2 cm by planar RBC scanning. One small hemangioma (2.0 cm) located adjacent to the heart was not found by either method. The sensitivities in detecting the hemangioma according to the site by planar imaging were 16.6% $(1.0\sim1.9cm)$, 66.7% $(2.0\sim2.9cm)$ and 83.3% (more than 3.0 cm) and by SPECT were 50.0%, 66.7% and 100%, respectively. Seven cases of non-hemangiomatous lesions did not show any significant increase in activity in the delayed blood pool images. It is concluded that $^{99m}Tc-RBC$ blood-pool SPECT scanning is clearly more sensitive in detecting small hemangioma than planar scanning and is, therefore, a choice of method for the detection of hepatic hemangioma.

• 대한핵의학회지
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• 제26권2호
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• pp.290-298
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• 1992

Although early diagnosis of urinary tract infection is important, the radiologic evaluation is still controversial because of the low sensitivity and the lack of cost-effectiveness. This study was carried out to evaluate the clinical utility of high resolution triple head $^{99m}Tc-DMSA$ SPECT imaging in urinary tract infection. We prospectively performed $^{99m}Tc-DMSA$ planar and SPECT imaging, ultrasound of kidney (US), intravenous pyelography (IVP) and voiding cystourethrography (VCU) in all 60 adult patients with UTI [26 with first episode of acute pyelonephritis (APN), 22 with recurrent APN, and 12 persistent asymptomatic pyuria] and 25 normal persons. To assess reversibility of the renal cortical defect (RCD), $^{99m}Tc-DMSA$ SPECT was repeated 1 to 8 months later in those patients with abnormal initial findings. Overall detection rate of $^{99m}Tc-DMSA$ SPECT imaging was 83% (50/60), but planar, US, IVP and VCU showed abnormal findings in 68%, 28%, 32% and 13%, respectively. 25 out of 27 patients with normal or single RCD were all normal in other radioligic studies. Only two patients showed vesicoureteral reflux (VUR) on VCU (grade I) and mild hydronephrosis on IVP. But, high proportion of those with multiple RCD showed abnormal findings on US (17/33), IVP (18/33), and VCU (7/33): 67% in any of these 3 studies. Especially, 3 out 7 patients with VUR showed multiple RCD on $^{99m}Tc-DMSA$ SPECT without any abnormality on IVP or US. 25 normal persons showed normal findings in all studies except one false positive finding on $^{99m}Tc-DMSA$ SPECT imaging. Follow-up $^{99m}Tc-DMSA$ SPECT was done in 28 patients (13 with single RCD, 15 with multiple RCD). All 13 patients with single RCD showed improvement. Those with multiple RCD presented improvement in 4, no change in 10, and aggravation in 1 on follow-up studies. With these results, we conclude: 1) $^{99m}Tc-DMSA$ SPECT imaging is superior to planar imaging, US, IVP or VCU in detection of renal lesion in urinary tract infection. $^{99m}Tc-DMSA$ SPECT is useful as a initial diagnostic tool in adult patients with urinary tract infection. 2) The multiple RCD on $^{99m}Tc-DMSA$ SPECT represent the high probability of irreversible tissue change and need of extensive urological work-up.

• 대한핵의학회지
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• 제30권1호
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• pp.139-144
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• 1996

갈륨스캔은 여러 종류의 염증성 질환 및 종양을 발견하기 위해 사용되고 있다. 특히 림프종은 갈륨스캔에서 양성율이 비교적 높은 종양으로 알려져 있다. 하지만 기존의 평면 영상만으로는 작은 크기의 종괴나 다른 장기에 의해 가려져 있는 경우에 위음성 결과를 보일 수 있었다. 최근 단일광자 방출 전산화 단층촬영(SPCET)을 도입하여 평면영상에 비해 더 나은 공간해상력으로 많은 정보를 얻고 있다. 저자들은 비호지킨 림프종 환자 30명을 대상으로 갈륨스캔 평면영상과 SPECT 영상을 얻어 비교하였다. 병변의 부위별로 두경부, 흉부, 복부에서 평면영상의 예민도는 각각 71%, 73%, 81%였으며, SPECT 영상의 예민도는 91%, 93%, 96%였다. CT 등 방사선학적 검사소견과 임상소견을 기준으로 하였을 때 위음성율은 평면영상의 경우 24%, SPECT 6.5%였다. 장의 방사능으로 인한 섭취와 폐문부 및 침샘의 비대칭적 섭취로 인한 위양성례가 4예 있었다. 결론적으로 비호지킨 림프종의 진단 및 병기를 결정하는데 있어서 갈륨스캔이 유용하며, SPCET 영상을 얻음으로써 더 나은 해부학적 위치 및 정확한 범위를 보여 줄 수 있을 것으로 생각된다.

• 대한핵의학회지
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• 제25권1호
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• pp.68-75
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• 1991

The value of $^{99}Tc-RBC$ scintigraphy and SPECT in the diagnosis of hepatic hemangioma was evaluated in 27 patients with 38 hemangiomas and 13 patients with 15 nonhemangiomas. Twenty four (63.2%) of 38 hemangiomas were detected by planar delayed RBC imaging, whereas 30 (78.9%) hemangiomas were detected by the delayed RBC SPECT. Increase in sensitivity was noted in nodules less than 2 cm in diameter. The smallest hemangioma shown by delayed RBC SPECT was 0.9 cm in diameter. All of nonhemangiomatous lesions show normal or decreased activity in delayed blood pool images. We concluded that $^{99m}Tc-RBC$ SPECT is an accurate method for the detection of hepatic hemangioma and is more sensitive than planar imaging in depicting small lesions.