• Journal of the Korean Society of Radiology
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• v.17 no.5
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• pp.701-707
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• 2023

In PET/CT, the injection volume of ¹⁸F-FDG directly affects the SUV(standard uptake value), which can affect the reading results. Therefore, it is important to inject the correct dose value of ¹⁸F-FDG. In this study, we performed the correlation between the residual radioactivity remaining in the syringe and catheter insertion device according to the number of flushing during ¹⁸F-FDG injection. CRC-25R dose calibrator, catheter insertion devices, 3 cc syringes and 50 cc physiological saline were used in this study, and the results were statistically analyzed. As a result, the total residual radioactivity of the syringe and catheter insertion device remained the highest at 5.84% after two flushing, and the least remained at 1.49% after five flushing. The correlation analysis results showed that the number of flushing had a negative correlation with the residual radioactivity of the syringe at -0.436 and the catheter insertion device at -0.300. As a result of one-way distributed analysis of the average according to the number of flushing, the syringe showed a significant decrease at 4 times, and the catheter insertion device showed a significant decrease at 5 times. However, considering that an average of 0.8% remains in the case of catheter insertion devices, four time flushing seems to be the most appropriate.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.140-144
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• 2014

Purpose: The recent surge in breast carcinoma patients is reported in a variety of statistics. Breast cancer occurs mainly from duct and lobulus: 85% is from the breast ducts. The present study is aimed to distinguish the difference in $SUV_{max}$ changing over time by identifying the type of cancers attacking from the duct. Materials and Methods: The subjects of the study are 291 female breast cancer patients who have visited the present PET/CT center from July 1, 2012 to July 23, 2013. Based on the pathological results, 248 IDC (invasive ductal carcinoma) patients and 43 DCIS (ductal carcinoma in situ) patients were selected. In the same manner as the general PET/CT scan (3.7 MBq/Kg), F-FDG was injected, followed by the primary test (Routine tests) after 1 hr, and the secondary test (Delay test) after another hr. $SUV_{max}$ was measured after setting ROI in the lesion based on the data from the two tests. Results: As the comparative result of the change in the lesion $SUV_{max}$ between the two groups, IDC group's $SUV_{max}$ showed M=7.11 and SD=5.405 in the primary test and increased M=7.11 and SD=5.405 in the secondary test (P<0.05); DCIS group's $SUV_{max}$ showed M=2.739, SD=1.229 in the primary test and increased M=2.614, SD=1.470 in the secondary test (P<0.05). Conclusion: As the comparative result of $SUV_{max}$ over time between the groups, IDC showed increased $SUV_{max}$ in the secondary test (Delay test) compared to the primary test (Routine test) (P=0.000); DCIS showed decreased $SUV_{max}$ in the secondary test (Delay test) compared to the primary test (Routine test) (P=0.039). It was confirmed through this study that the change in $SUV_{max}$ has occurred over time by the type of breast cancer (IDC or DCIS) occurring from the breast ducts. However, the onset of breast cancers (ILC, LCIS) from the lobulus was not discussed due to the lack of samples. Future research on the breast cancers from the lobulus is suggested.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.13-17
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• 2010

Purpose: Partial volume effect (PVE) is the phenomenon to lower the accuracy of image due to low estimate, which is to occur from PET/CT 3D image acquisition. The more resolution is declined and the lesion is small, the more it causes a big error. So that it can influence the test result. Studied the optimum image reconstruction method by using variation of parameter, which can influence the PVE. Materials and Methods: It acquires the image in each size spheres which is injected $^{18}F$-FDG to hot site and background in the ratio 4:1 for 10 minutes by using NEMA 2001 IEC phantom in GE Discovey STE 16. The iterative reconstruction is used and gives variety to iteration 2-50 times, subset number 1-56. The analysis's fixed region of interest in detail part of image and compute % difference and signal to noise ratio (SNR) using $SUV_{max}$. Results: It's measured that $SUV_{max}$ of 10 mm spheres, which is changed subset number to 2, 5, 8, 20, 56 in fixed iteration to times, SNR is indicated 0.19, 0.30, 0.40, 0.48, 0.45. As well as each sphere's of total SNR is measured 2.73, 3.38, 3.64, 3.63, 3.38. Conclusion: In iteration 6th to 20th, it indicates similar value in % difference and SNR ($3.47{\pm}0.09$). Over 20th, it increases the phenomenon, which is placed low value on $SUV_{max}$ through the influence of noise. In addition, the identical iteration, it indicates that SNR is high value in 8th to 20th in variation of subset number. Therefore, to reduce partial volume effect of small lesion, it can be declined the partial volume effect in iteration 6 times, subset number 8~20 times, considering reconstruction time.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.6
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• pp.456-463
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• 2008

Purpose: We evaluated the incidence and malignant risk of focal breast lesions incidentally detected by $^{18}F-FDG$ PET/CT. Various PET/CT findings of the breast lesions were also analyzed to improve the differentiation between benign from malignant focal breast lesions. Materials & Methods: The subjects were 3,768 consecutive $^{18}F-FDG$ PET/CT exams performed in adult females without a history of breast cancer. A focal breast lesion was defined as a focal $^{18}F-FDG$ uptake or a focal nodular lesion on CT image irrespective of $^{18}F-FDG$ uptake in the breasts. The maximum SUV and CT pattern of focal breast lesions were evaluated, and were compared with final diagnosis. Results: The incidence of focal breast lesions on PET/CT in adult female subjects was 1.4% (58 lesions in 53 subjects). In finally confirmed 53 lesions of 48 subjects, 11 lesions of 8 subjects (20.8%) were proven to be malignant. When the PET/CT patterns suggesting benignancy (maximum attenuation value>75 HU or <30HU; standard deviation of mean attenuation > 20) were added as diagnostic criteria of PET/CT to differentiate benign from malignant breast lesions along with maximum SUV, the area under ROC curve of PET/CT was significantly increased compared with maximum SUV alone ($0.680{\pm}0.093$ vs. $0.786{\pm}0.076$, p<0.05). Conclusion: The malignant risk of focal breast lesions incidentally found on $^{18}F-FDG$ PET/CT is not low, deserving further diagnostic confirmation. Image interpretation considering both $^{18}F-FDG$ uptake and PET/CT pattern may be helpful to improve the differentiation from malignant and benign focal breast lesion.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.5
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• pp.257-262
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• 2006

Purpose: The standard protocol using large volume of oral contrast media may cause gastrointestinal discomfort and contrast-related artifacts in PET/CT. The aim of this study was to evaluate the usefulness of low dose oral contrast in $^{18}F-FDG$ PET/CT. Materials and Methods: We retrospectively reviewed the whole-body PET/CT images in a total of 435 patients. About 200 ml of oval contrast agent (barium sulfate) was administered immediately before injection of $^{18}F-FDG$. The FDG uptake of intestines was analyzed by visual and semi- quantitative method on transaxial, coronal and saggital planes. Results: Seventy (16%, 113 sites) of 435 images showed high FDG uptake (peak SUV > 4); 50 (74%, 84 sites) with diffuse and 20 (15%, 29 sites) with focal uptake. The most commonly delivered site of oral contrast media was small bowel (n=27, 39%). On PET/CT images, FDG uptake coexisted with oral contrast media in 26 patients (54%, 38 sites) with diffuse pattern and 9 (45%, 9 sites) with focal pattern, and by sites, those were 38 (45%) and 9 (31%), respectively. In small bowel regions, the proportion of coexistence reached as high as 61% (29/47 sites). A visual analysis of available non-attenuation corrected PET images of 27 matched regions revealed no contrast-related artifact. Conclusion: We concluded that the application of low dose contrast media could be helpful in the evaluation of abdominal uptake in the FDG PET/CT image.

• Journal of radiological science and technology
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• v.45 no.3
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• pp.225-232
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• 2022

Fine dust threatens human health in various forms, depending on the particle size, such as by causing respiratory, cardiovascular, and brain diseases, after entering the body via the lungs. The aim of this study was to correlate fine dust exposure with changes in brain blood flow in Sprague Dawley rats by using micro-positron emission tomography and elucidate the possibility of developing cerebrovascular diseases caused by fine dust. The subjects were exposured to an average fine dust (particulate matter 2.5) of 206.2 ± 7.74 to ten rats four times a day, twice a day for 90 min. Before the experiment, they were maintained at NPO to the maximize the intake of ¹⁸F-fluorodeoxy glucose(¹⁸F-FDG) and minimize changes in the ¹⁸F-FDG biomass depending on the ambient environment and body temperature of the rats. PET images were acquired in the list mode 40 min after injecting ¹⁸F-FDG 44.4 MBq into the rats tail vein using a micro-PET scanner pre and post exposure to fine dust. We found that the whole brain level of ¹⁸F-FDG standardized uptake value in rats averaged 5.21 ± 0.52 g/mL pre and 4.22 ± 0.48 g/mL post exposure to fine dust, resulting in a statistically significant difference. Fine dust was able to alter brain activity after entering the body via the lungs in various forms depending on the particle size.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.59-63
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• 2019

Purpose The motion due to respiration of patients undergoing PET/CT is a cause of artifacts in image and registration error between PET and CT images. The degree of displacement and distortion for tumor, which affects the measurement of Standard Uptake Value (SUV) and lesion volume, is especially higher for tumors that is small or located at the base of lungs. The purpose of this study was to evaluate the usefulness of prone position in the correction of image distortion due to respiration of patients in PET/CT. Materials and Methods The imaging equipment used in this study was PET/CT Discovery 600 (GE Healthcare, MI, USA). 20 patients whose lesions were identified in the middle and lower lungs from May to August 2018 were enrolled in this study. After acquiring whole body image in the supine position, additional images of the lesion area were obtained in the prone position with the same conditions. SUVmax, SUVmean, and volume of the lesion were measured for each image, and the displacement of the lesion on PET and CT images were measured, compared, and analyzed. Results The SUVmax, SUVmean, and volume, and displacement of the lesion were $4.72{\pm}2.04$, $3.10{\pm}1.38$, $4.68{\pm}3.20$, and $4.64{\pm}1.88$, respectively for image acquired in the supine position and $5.89{\pm}2.42$, $3.97{\pm}1.65$, $2.13{\pm}1.09$, and $2.24{\pm}0.84$, respectively for image acquired in the prone position, indicating that, for all the lesions imaged, SUVmax and SUVmean were higher and volume and displacement were smaller in the images acquired in prone position compared to those acquired in supine one(p<0.05). Conclusion These results showed that the prone position PET/CT imaging improves the quality of the image by increasing the SUV of the lesion and reducing the respiratory artifacts caused by registration error between PET and CT images. It is considered that the PET/CT imaging in the prone position is helpful in the diagnosis of the disease as an economical and efficient methods that correct registration error for the lesions in basal lung and reduce artifacts.

• The Korean Journal of Nuclear Medicine Technology
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• v.19 no.1
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• pp.51-56
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• 2015

Purpose As medical radiation exposures on patients are being social issues an interest in a relief of radiation exposures on patients is increasing. Further, there are many cases where some patients among who are getting PET/CT tests choose to get implanted with metal artifacts in their bodies. This study is to find out effects of presence or absence of metal artifacts when dose change or CT attenuation correction for the relief of radiation exposures are applied using phantoms through changes in standard uptake value (SUV). Materials and Methods GE company's Discovery 710 machine was used for PET/CT test equipments. We used NEMA IEC body phantoms. We also used screw and mesh cage made of titanium which are used in real clinical processes for the metal artifacts. Two experiments were conducted: One is to test and measure repeatedly about SUV about differences in CT attenuation corrections according to dose changes and another is to do the same procedure for SUV about the presence and absence of the metal artifacts. We injected $^{18}F-FDG$ into NEMA IEC body phantoms with a TBR ratio of 4:1 and then put the metal material into the transformation phantoms. Once a scanning for the metal artifacts was done we eliminated the metal artifacts and went on non-metal artifacts. For the each two experiments, we scanned repeatedly with CT kVp (140, 120, 100, 80) and mA (120, 80, 40, 20, 10) for an experimental condition. For PET, we reconstructed each with standard AC (STD) technique and quantitation achieved cnsistently QAC) technique among CT attenuation correction methods. We conducted a comparative analysis on measured average values and variations which were measured through repeated measure of SUV of region 1, 2, 3 spheres for each conditions of non-metal /metal scan. Results For each kVp, 120, 80, 40 (mA) of non/metal (screw, mesh cage) showed low frequency of fluctuation rates of above 2%. In 20, 10 mA above 2% of fluctuation rates appeared in high frequency. Also, when we compared the fluctuation rates of STD and QAC techniques in non/metal (screw, mesh cage) tests QAC technique showed about 1-10% of differences for each conditions compared to STD technique. In addition, metal types did not have significant effects on fluctuation rates. Conclusion We confirmed that SUV fluctuation rates for both STD and QAC techniques increase as dosage is lower. We also found that the SUV of PET data was maintained steadily in a low dosage for QAC technique when compared with STD technique. Hence, when the low dosage is used for the relief of radiation exposures on patients QAC technique may be exploited helpfully and this could be applied in the same way for patients with metal artifacts implanted in their bodies.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.34-37
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• 2012

Purpose: To verify the optimal scan time per bed for clinical application, we evaluated the quality of $^{18}F$-FDG images with varying scan times in a phantom and 20 patients with 38 lesions using a Philips (TOF) PET/CT scanner. Materials and Methods: The PET/CT images of a NEMA IEC body phantom and 20 patients (16 males, 4 females) were acquired for 5 different scan times of 20-100 sec per bed with intervals of 20 sec. The activity ratio of hot spheres (diameter of 17 [H1], 22 [H2] and 28 [H3] mm) to the background region in the IEC body phantom was 8-to-1. The contrast recovery coefficient (CRC) and standard uptake value (SUV) based on ROIs of hot spheres and background region were calculated. The noise in each background region was estimated as the ratio of SD of counts to the mean counts in the background region. On the patient image, the injected dose of $^{18}F$-FDG was $444{\pm}74$ MBq and the SUVs in the 38 hot lesions were measured. Results: The two scan time groups (LT-60 [<60 sec] and GT-60 [${\geq}60$ sec]) were compared. In the phantom study, the coefficient of deviations (CVs, %) of CRC and SUV in LT-60 (H1: 14.2 and 7.3, H2: 11.4 and 7.8, H3: 4.9 and 3.2) were higher than GT-60 (H1: 8.9 and 2.8, H1: 8.2 and 5.0, H3: 2.0 and 1.6). In the patient study, the mean CV of CRC and SUV in LT-60 (4.0) was higher than GT-60 (1.2). Conclusion: This study showed that noise increased as the scan time decreased. High noise for the scan time <60 sec per bed yielded high variation of SUV and CRC. Therefore, considering PET/CT image quality, the scan time per bed in the TOF PET/CT scanner should be at least ${\geq}60$ sec.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.2
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• pp.37-43
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• 2017

Purpose Recently PET/CT image's attenuation correction is used CTAC(Computed Tomgraphy Attenuation Correction). it can quantitative evaluation by SUV(Standard Uptake Value). This study's purpose is to evaluate SUV and to find proper CT kernel using CTAC with applied various CT kernel to PET/CT construction. Materials and Methods Biograph mCT 64 was used for the equipment. We were performed on 20 patients who had examed at our hospital from february through March 2017. Using NEMA IEC Body Phantom, The data was reconstructed PET/CT images with CTAC appiled various CT kernel. ANOVA was used to evaluated the significant difference in the result. Results The result of measuring the radioactivity concentration of Phantom was B45F 96% and B80F 6.58% against B08F CT kernel, each respectively. the SUVmax increased to B45F 0.86% and B80F 6.54% against B08F CT kernel, In case of patient's parts data, the Lung SUVmax increased to B45F 1.6% and B80F 6.6%, Liver SUVmax increased to B45F 0.7% and B80F 4.7%, and Bone SUVmax increased to B45F 1.3% and B80F 6.2%, respectively. As for parts of patient's about Standard Deviation(SD), the Lung SD increased to B45F 4.2% and B80F 15.4%, Liver SD increased to B45F 2.1% and B80F 11%, and Bone SD increased to B45F 2.3% and B80F 14.7%, respectively. There was no significant difference discovered in three CT kernel (P >.05). Conclusion When using increased noise CT kernel for PET/CT reconstruction, It tends to change both SUVmax and SD in ROI(region of interest), Due to the increase the CT kernel number, Sharp noise increased in ROI. so SUVmax and SD were highly measured, but there was no statistically significant difference. Therefore Using CT kernel of low variation of SD occur less variation of SUV.