• The Korean Journal of Nuclear Medicine Technology
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• v.17 no.2
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• pp.48-52
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• 2013

Purpose: The Molybdenum which is the raw material of $^{99}Mo-^{99m}Tc$ 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. So $^{99}Mo-^{99m}Tc$ generator using$(n,{\gamma})^{99}Mo$ is developed by Korea Atomic Energy Research Institute (KAERI). Medicinal availability of this generator is evaluated in this study. Materials and Methods: The radioactivity of $^{99m}Tc$ eluted in generator 1, 2 and 3 unit developed by KAERI was measured. The quality control test of generator such as appearance test, pH test, LAL test, sterility test, chemical impurity (Al) test and radiochemical purity test were performed. Planar and SPECT/CT image sof SD rat (6 weeks, Female) at 2 hr after injection of $^{99m}Tc-HDP$ (hydroxymethylenediphosphonate) (TechneScan HDP, Malinckrodt Medical, Dutch) and $^{99m}Tc-DPD$ (diphosphono-1, 2-propanedicarboxylicacid) (TECEOS, CIS bio international, France) which were labeled with $^{99m}Tc$ eluted in KAERI and commercial generator (40.5 GBq, Malinckrodt Medical, Dutch) using SPECT/CT camera (Symbia, Siemense, Germany) were obtained respectively. Results: The mean radioactivity of $^{99m}Tc$ elution generator 1unit was 4.18 GBq (113 mCi), generator 2 unit was 4.73 GBq (128 mCi) and generator 3 unit was 3.33 GBq (90 mCi). All quality control tests were within normal limit except pyrogentest. Pyrogen test was positive. Planar and SPECT/CT images of rat injected $^{99m}Tc-HDP$ which was labeled with $^{99m}Tc$ eluted in commercial generator show increased uptake in bone, stomach and bowl. Planar images show increased uptake in liver and bone in case of $^{99m}Tc-DPD$. However, images of rat injected $^{99m}Tc-HDP$ and $^{99m}Tc-DPD$ which were labelled $^{99m}Tc$ eluted in KAERI generator show increased uptake in bone, liver and spleen. Conclusion: If shortcoming is removed such as pyrogen and liver appearance, domestic role as an alternative generator is thought to be able to fill and to secure the national medical service by supplying $^{99m}Tc$ when the supply of $^{99m}Tc$ be comes short.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.1
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• pp.35-39
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• 2009

Purpose: Diagnostic and functional imaging softwares in Nuclear Medicine have been developed significantly. But, there are some limitations which like take a lot of time. In this article, we introduced that the basic concept of macro to help understanding macro and its application to Brain SPECT processing. We adopted macro software to SPM processing and PACS verify processing of Brain SPECT processing. Materials and Methods: In Brain SPECT, we choose SPM processing and two PACS works which have large portion of a work. SPM is the software package to analyze neuroimaging data. And purpose of SPM is quantitative analysis between groups. Results are made by complicated process such as realignment, normalization, smoothing and mapping. We made this process to be more simple by using macro program. After sending image to PACS, we directly input coordinates of mouse using simple macro program for processes of color mapping, adjustment of gray scale, copy, cut and match. So we compared time for making result by hand with making result by macro program. Finally, we got results by applying times to number of studies in 2007. Results: In 2007, the number of SPM studies were 115 and the number of PACS studies were 834 according to Diamox study. It was taken 10 to 15 minutes for SPM work by hand according to expertness and 5 minutes and a half was uniformly needed using Macro. After applying needed time to the number of studies, we calculated an average time per a year. When using SPM work by hand according to expertness, 1150 to 1725 minutes (19 to 29 hours) were needed and 632 seconds (11 hours) were needed for using Macro. When using PACS work by hand, 2 to 3 minutes were needed and for using Macro, 45 seconds were needed. After applying theses time to the number of studies, when working by hand, 1668 to 2502 minutes (28 to 42 hours) were needed and for using Macro, 625 minutes (10 hours) were needed. Following by these results, it was shown that 1043 to 1877 (17 to 31 hours were saved. Therefore, we could save 45 to 63% for SPM, 62 to 75% for PACS work and 55 to 70% for total brain SPECT processing in 2007. Conclusions: On the basis of the number of studies, there was significant time saved when we applied Macro to brain SPECT processing and also it was shown that even though work is taken a little time, there is a possibility to save lots of time according to the number of studies. It gives time on technologist's side which makes radiological technologist more concentrate for patients and reduce probability of mistake. Appling Macro to brain SPECT processing helps for both of radiological technologists and patients and contribute to improve quality of hospital service.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.1
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• pp.47-50
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• 2009

Purpose: Presently, any exact standard of radiopharmaceutical doses in pediatric nuclear medicine doesn't exist in the universe. So hospitals are following by manual of vial kit or guidelines of America and Europe based on recommended adult doses adjusted for body mass (MBq/kg) or body surface area (MBq/$m^2$). However, especially for children younger than 1 year and heavier than 50 kg, it's hard to estimate exact dosage for those children. Materials and Methods: In order to obtain objective data of multipliers for pediatric studies, we surveyed 4 major hospitals in Korea. After receiving feedbacks, we changed dosage to multiplier. And we compared multipliers of Korea to America's and Europe's. Results: Most hospitals in Korea are following by body mass formula (MBq/kg). On the other hand, standards don't include proper factors for a child younger than 1 year and heavier than 50 kg. Multipliers for 3 kg children who are injected lower doses than needed are America:0.12, Europe:0.09, Korea:0.05, multipliers for 30 kg children who are injected proper doses are America:0.58, Europe:0.51, Korea:0.45 and multipliers for 60 kg children who are injected more doses than needed are America:0.95, Europe:0.95, Korea:0.91. Conclusions : Through the survey, when calculating doses for children, usually output doses are based on adult doses adjusted for body mass (MBq/kg) but research has shown that standards of all of the compared standards don't reflect exact multipliers for children younger than 1 year and heavier than 50 kg. Therefore, we should give an effort to reduce needless radiation exposure in children by establishing a proper doses standard and also developing better image reconstruction software.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.1
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• pp.105-110
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• 2010

Purpose: Three phase bone scan was considered sensitive in Patients with Reflex Symphathetic Dystrophy Syndrome (RSDS). Generally, three phase bone scan in the RSDS patients shows increased uptake of one side extremity joint. But three phase bone scan has been performed with flow, blood pool and delayed scan. We performed blood pool half body scan in order to investigate its usefulness. Materials and Methods: From October 2007 to September 2009, three phase bone scan (flow, blood pool, half body blood pool, delayed) was performed after injection of 750 MBq of $^{99m}Tc$-DPD in diagnosed patients with RSDS (M:F=8:7, R:L=9:6). For quantitative analysis, we obtained the count ratios of bilateral hands by drawing a region of interest (ROI) in the three phase images and compared with the count ratios of shoulders in half body blood pool and delayed images. Results: In flow images, right/left ratios were $1.09{\pm}0.53$. In blood pool images, right/left ratios were $1.13{\pm}0.47$ (hand), $1.08{\pm}0.26$ (shoulder). In delayed images, right/left ratios were $1.24{\pm}0.75$ (hand), $1.11{\pm}0.31$ (shoulder). As a result, Log of right/left counts of the others and that of shoulder blood pool image were correlated well with statistical significance (Spearman's R, p<0.005 SPSS for windows ver.12.0). Conclusion: Half body blood pool scan may be helpful in the diagnosis of patients with RSDS. Moreover, Half body blood pool scan reduced false negative and false positive rates. In order to improve agreement on interpretation of RSDS, Blood pool half body scan should be established as common criteria.

• 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.

• Journal of radiological science and technology
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• v.29 no.4
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• pp.267-274
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• 2006

The evaluation of GB stones with ultrasound has proved to be useful procedure in patient with symptoms of cholelithiasis. GB is evaluated for size, wall thickness, presence of internal reflections within the lumen and posterior acoustic shadowing or enhancement in Ultrsonography. The patient position should be shifted during procedure to demonstrate further the presence of stone within the GB. Patient scanned at the Rt. subcostal region in supine, right lateral, Lt. down decubitus, and upright sitting position. So GB stone should shift to dependent area of GB. Often, GB is not markedly distended in the presence of cholethiasis, and so the diagnosis becomes more difficult. One of the more difficult areas for detection of a GB stones are embeded in the cystic duct region. And since the GB is adjacent to the duodenum and hepatic flexure, its may be difficult to visualizing a GB stone. When patient study position changes frome supine to other position, stones displaced the site. But if its are polyps, not changes the site whatever patient positions. It is very important to what make different GB stones or polyps. We have studied about mobility of GB stones according to the patients position(supine, Lt. down decubitus, $30^{\circ} LAO. sitting and hand-knee). So we have a result, stones wherever localized within the GB, changed 100% its position in the hand-knee position and the others appeared at least 90%. In this study, when a large stones are located through fundus-body and body-neck, does not changing the stones position in spite of varied patient's positions. But hand-knee positions can identified GB stones, because its make changed the position of stons from posterior wall to anterior wall within the GB. We recommend the hand-knee position for differentiation GB stones from polyps.

• Journal of radiological science and technology
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• v.39 no.4
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• pp.557-564
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• 2016

Effects of Gamma camera imaging on gamma ray counting rates as a function of use and density of the iodine contrast medium currently in primary use for clinics, and changes in gamma ray counting rates as a function of the contrast medium status upon attenuation correction using a CT absorption coefficient in an SPECT/CT attenuation correction will be considered herein. For experimental materials used $^{99m}TcO_4$ 370 MBq and Pamiray 370 mg, Iomeron 350 mg, Visipaque 320 mg, Bonorex 300 mg of iodine contrast medium. For image acquisition, planar imaging was consecutively filmed for 1, 2, 3, 4, 5 min, respectively, 30 min after administration of $^{99m}TcO_4$. while 60 views were filmed per frame for 20 min at 55 min for the SPECT/CT imaging. In planar imaging, the gamma ray counting rates as a function of filming time were reduced showing a statistically significant difference when mixed according to the type of contrast medium density rather than when the radioactive isotope $^{99m}TcO_4$ and the saline solution were mixed. In the tomography for mixing of the radioactive isotope $^{99m}TcO_4$ and saline solution, the mean counting rate without correction by the CT absorption coefficient is $182{\pm}26counts$, while the counting rate with correction by the CT absorption coefficient is $531.3{\pm}34counts$. In the tomography for mixing of the radioactive isotope $^{99m}TcO_4$ and the saline solution with the contrast medium, the mean values before attenuation correction by CT absorption coefficient were $166{\pm}29$, $158.3{\pm}17$, $154{\pm}36$, and $150{\pm}33counts$ depending on the densities of the contrast medium, while the mean values after attenuation correction were $515{\pm}03$, $503{\pm}10$, $496{\pm}31$, and $488.7{\pm}33counts$, showing significant differences in both cases when comparatively evaluated with the imaging for no mixing of the contrast medium. Iodine contrast medium affects the rate of gamma ray. Therefore, You should always be preceded before another test on the day of dignosis.

• Journal of radiological science and technology
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• v.27 no.3
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• pp.31-41
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• 2004

Attention deficit hyperactivity disorder(ADHD)is one of the most common psychiatric disorders in childhood, especially school age children and persisting into adult. ADHD is affected 7.6% in our children, Korea. and persisting into $15{\sim}20%$ in adult. And it is characterized by hyperactivity, inattention and impulsivity. Brain imaging is one of way to diagnosis for ADHD. Brain imaging studies may be provide information two types - structural and functional imaging. Structural and functional images of the brain play an important role in management of neurologic and psyciatric disorders. Brain SPECT, with perfusion imaging radiopharmaceuticals is one of the appropriate test to diagnosis of neurologic and psychiatric diseases. Ther are a few studies about separated analysis between boys and girls ADHD SPECT brain images. Selection of Probability level(P-value) is very important to determind the abnormalities when analysis a data by SPM. SPM is a statistical method used for image analysis and determine statistical different between two groups-normal and ADHD. Commonly used P-value is P<0.05 in statistical analysis. The purpose of this study is to evaluation of blood flow clusters distribution, between boys and girls ADHD. The number of normal boys are 8(6-7y, average : $9.6{\pm}3.9y$) and 51(4-11y, average : $9.0{\pm}2.4$) ADHD patients, and normal girls are 4(6-12y, average : $9{\pm}2.4y$) and 13(2-13y, average $10{\pm}3.5y$) ADHD patiens. Blood flow tracer $^{99m}Tc-ethylcysteinate$ dimer(ECD) injected as rCBF agent and take blood flow images after 30 min. during sleeping by SPECT camera. The anatomical region of hyperperfusion of rCBF in boys ADHD group is posterior cingulate gyrus and hyperperfusion rate is 15.39-15.77% according to p-value. And girls ADHD group appears at posterior cerebellum, Lt. cerbral limbic lobe and Lt. Rt. cerebral temporal lobe. These areas hyperperfusion rate are 24.68-31.25%. Hypoperfusion areas in boys ADHD,s brain are Lt. cerebral insular gyrus, Lt. Rt. frontal lobe and mid-prefrontal lobe, these areas decresed blood flow as 15.21-15.64%. Girls ADHD decreased blood flow regions are Lt. cerebral insular gyrus, Lt. cerebral frontal and temporal lobe, Lt. Rt. lentiform nucleus and Lt. parietal lobe. And hypoperfusion rate is 30.57-30.85% in girls ADHD. The girls ADHD group's perfusion rate is more variable than boys. The studies about rCBF in ADHD, should be separate with boys and girls.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.65-69
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• 2011

Purpose: Normal pancreas has low uptake rate in $^{18}F$-FDG PET scan. However, it is possible to diagnose malignancy of pancreatic cancer which has high uptake rate. Many studies approve a high prevalence of diabetes in pancreatic cancer and if the blood glucose level (BGL) is over the normal range, FDG uptake will be decreased and there will be inconvenience for patients from the delay time to reduce the high BGL or could cause difficulty to arrange the schedule. Therefore, we studied the relation of BGL and image quality in pancreatic cancer on PET. Materials and Methods: A hundred patients had PET scan. The prevalence of pancreatic cancer and diabetes were evaluated using SPSS ver. 17. The fasting BGL of patients were examined and sorted as diabetes mellitus (DM) group and Non-DM group. For the evaluation, patients were divided into 3 groups (Non-DM, DM; BGL${\geq}7.0mmol/L$, and DM; BGL<7.0 mmol/L). The ROI was drown on Liver and Lung for the PET imaging analysis. Results: Fifty three male and forty seven female were in the patients. The average age was $60.1{\pm}13.5$. There were 36 patients (male: 22, female: 14, 36%) who had pancreatic cancer with DM. There were 15 patients who showed over 7.0 mmol/L in their fasting BGL and 85 patients who showed under 7.0 mmol/L in their fasting BGL. Among the Non-DM, DM; BGL${\geq}7.0mmol/L$, and DM; BGL<7.0 mmol/L, there was not a statistical significance (p>0.05). Conclusion: The prevalence of pancreatic cancer was comparatively high in this study. If the fasting BGL was slightly over the normal BGL, we believe it will not give a severe disturbance when the patients have PET scan. Furthermore, the examination schedule doesn't need to change and the inconvenience from the delay of patients preparation will be reduced.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.51-57
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• 2011

Purpose: The aim of this study is to identify clinical usefulness of Wide Beam Reconstruction (WBR) which is called Xpress.cardiac$^{TM}$ to confirm the agreement between segmental perfusion and regional wall motion in myocardium compared to conventional OSEM method. Materials and Methods: Subjects were separated two groups. First group was composed of 20 normal control group. Second group was composed of 10 patients (abnormal group) who had coronary artery disease. Subjects underwent myocardial perfusion SPECT ($^{201}Tl$ rest and $^{99m}Tc$-MIBI stress). Image acquisition and reconstruction were that rest stage was each step per 30, 15 seconds and stress stage was each step per 25, 13 seconds, OSEM and WBR methods were applied. Segmental perfusion and regional wall motion were applied 20-segment model of QPS, QGS algorithm in AutoQuant. Status of perfusion was composed of 5 point scoring system (0=normal, 1=mild, 2=moderate, 3=severe hypokinesia, 4=dyskinesia). Status of regional wall motion was also composed of 5 point scoring (0=normal, 1=mild, 2=moderate, 3=severe hypokinesia, 4=dyskinesia). We evaluated the agreement between conventional OSEM and WBR through automatic quantification value. Results: The agreement of rest segmental perfusion between conventional OSEM and WBR in normal patients was 99% (396/400, k=0.662, p<0.0001) and one of rest regional wall motion was 83.8% (335/400, k=0.283), the agreement of stress segmental perfusion was 95.8%(383/400, k=0.656), one of stress regional wall motion was 87.3% (349/400, k=0.390). The match rate of rest segmental perfusion in abnormal patients was 83% (166/200, k=0.605, p<0.0001) and one of rest regional wall motion was 55.5% (111/200, k=0.385), the agreement of stress segmental perfusion was 79.5% (159/200, k=0.682), one of stress regional wall motion was 63.5% (127/200, k=0.486). Conclusion: Compared to conventional OSEM, WBR method had a good agreement of segmental perfusion in myocardium in normal and abnormal groups. However regional wall motion showed meaningful low agreement. Although WBR offers high resolution and contrast ratio, it is not useful method for gated myocardial perfusion SPECT.