• Journal of radiological science and technology
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• v.31 no.4
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• pp.389-399
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• 2008

Corrections of attenuation, scatter and resolution are important in order to improve the accuracy of single photon emission computed tomography (SPECT) image reconstruction. Especially, the heart movement by respiration and beating cause the errors in the corrections. Myocardial phantom is used to verify the correction methods, but there are many different parts in the current phantoms in actual human body. Therefore the results using a phantom are often considered apart from the clinical data. We developed a new phantom that implements the human body structure around the thorax more faithfully. The new phantom has the small mediastinum which can simulate the structure in which the lung adjoins anterior, lateral and apex of myocardium. The container was made of acrylic and water-equivalent material was used for mediastinum. In addition, solidified polyurethane foam in epoxy resin was used for lung. Five different sizes of myocardium were developed for the quantitative gated SPECT (QGS). The septa of all different cardiac phantoms were designed so that they can be located at the same position. The proposed phantom was attached with liver and gallbladder, the adjustment was respectively possible for the height of them. The volumes of five cardiac ventricles were 150.0, 137.3, 83.1, 42.7 and 38.6ml respectively. The SPECT were performed for the new phantom, and the differences between the images were examined after the correction methods were applied. The three-dimensional tomography of myocardium was well reconstructed, and the subjective evaluations were done to show the difference among the various corrections. We developed the new cardiac and torso phantom, and the difference of various corrections was shown on SPECT images and QGS results.

• The Korean Journal of Nuclear Medicine
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• v.37 no.6
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• pp.364-373
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• 2003

Purpose: For good quality of myocardial perfusion images, an approximately 30 min to 1 hour of waiting time after radiopharmaceutical injection and ingestion of fatty meal are asked of the patients. The aim of this study was to investigate the shortening of waiting time after radiopharmaceutical injection and improvement of image quality using natural plant extracts that promote bile excretion. Materials and Methods: Ten volunteers participated in protocol 1 (7 men, 3 women; mean age, $24.1{\pm}2.4$ years) and protocol 2 (8 men, 2 women; mean age, $26.1{\pm}2.9$ years), respectively. For the modified method of both protocols, subjects took natural plant extracts 15 minutes before the first injection of $^{99m}Tc$ MIBI without laking fatty meals. Control (Conventional) methods were peformed with intake of a fatty meal 20 to 30 minutes after $^{99m}Tc$ MIBI injection. Results: As the results of protocol 1 and 2, the ratio of myocardial to lung ratio were not different between modified and conventional method. Liver to lung ratio of modified method showed significantly lower value than that of conventional method. In modified method, myocardial to liver ratio was higher persistently. In protocol 2, natural plant extracts took before the first injection of $^{99m}Tc$ MIBI exerted accelerating effect of excretion of bile juice into Intestine until the end of examination. Conclusion: These results represent that natural plant extracts for facilitation of bile excretion before injection of $^{99m}Tc$ MIBI may provide better quality of myocardial perfusion images without the need for preparations such as ingestion of fatty meal within the 2 hours compared with conventional method.

• Tuberculosis and Respiratory Diseases
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• v.43 no.1
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• pp.54-62
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• 1996

Background: $^{99m}Tc$ MIBI(Methoxyisobutylisonitrile complex), a member of the isonitrile class of coordination compounds, is a lipophilic cation presently under investigation for clinical use as myocardial perfusion imaging agent and is widely used to detect myocardial infarction. Preliminary reports indicate that $T_1$-201 accumulate in human neoplasm and several authors reported $^{99m}Tc$ MIBI may also localized in primary malignant tumor and metastatic deposits from lung cancer. We evaluated the uptake of $^{99m}Tc$ MIBI in lung cancer and localization of mediastinal and other site metastasis, and compared the benign lesion of the lung. Method: Thirty four patients of lung cancer and ten patients of benign lung lesion were studied with chest CT and $^{99m}Tc$ MIBI Lung SPECT. $^{99m}Tc$ MIBI uptake ratio was assessed by TR/NL(Lung lesion/ Normal area), HT/NL (Heart/Normal area) and HT/TR(Heart/Lung lesion). Results: 1) All lung cancer patients showed increased uptakes of $^{99m}Tc$ MIBI in malignant lung lesion and Tc-99m MIBI uptake was also increased in mediastinal and lymph node metastasis except two cases. 2) There was significant different ratio of TR/NL between malignant and benign lesion, $3.79{\pm}1.82$ and $1.67{\pm}0.63$ on planar images, respectively(p<0.001). 3) There was no significant difference of $^{99m}Tc$ MIBI uptake ratio between squamous cell carcinoma, small cell carcinoma and adeno carcinoma($3.64{\pm}1.66$, $3.57{\pm}0.72$, $4.31{\pm}2.28$ respectively). Conclusion: $^{99m}Tc$ MIBI lung SPECT was useful in the localization of tumor and mediastinal or other site metastatic lesion in lung cancer and also in the differential diagnosis between benign and malignant lesion.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.150-154
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• 2010

Purpose: Ejection fraction (EF) is one of the most important factors that evaluate heart function. Recently, according to echocardiography and myocardial perfusion SPECT, the number of gated blood pool scan (planar GBP) is declining. Measurement of left ventricular ejection fraction using gated blood pool SPECT (GBPS) is known as relatively correspond with echocardiography. We compared EF derived from plnar GBP, GBPS and echocadiography using modified simpson method to determine the accuracy. Materials and Methods: From January 2007 to June 2010, planar GBP and GBPS were performed on 34 patients who admitted to Pusan National University Hospital (men 23, women 11, mean age $52.6{\pm}27.2$). Each patient was injected with $^{99m}{TcO_4}^-$ of 20 mCi after pyrophosphate injection and then scanned using both planar GBP and GBPS techniques. For image analysis, we use ADAC Laboratories, Ver. 4.20 software. The result analyzed was processed by SPSS 17.0 Win statistic program and statistical method applied in data analysis is one-way anova, Tukey's post hoc test, pearson correlation test. Results: One-way anova test show no significant difference (planar GBP $56.3{\pm}13.9%$; GBPS $60.4{\pm}16.0%$; echocardiography $59.1{\pm}14.4%$, p=0.486, p>0.05). Tukey's post hoc test show no significant difference (planar GBP-echocardiography p=0.697; GBPS-echocardiography p=0.928; planar GBP-GBPS p=0.469, p>0.05). Values for EF obtained with planar GBP and GBPS correlated well with those obtained with echocardiography (planar-echocardiography r=0.697; GBPS-echocardiography r=0.928; planar GBP-GBPS r=0.469). Conclusion: The problems of accuracy and reproducibility for planar GBP still remain. But planar GBP is a safe and non-invasive method. In addition, planar GBP is useful to evaluate patient with low resolution echocardiography images. GBPS is not appicated clinically. but GBPS can be obtain various left ventricular functional parameters. planar GBP, GBPS and echocardiography show a good correlation between each other. Therefore, planar GBP and GBPS are useful for evaluating left ventricular ejection fraction.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.70-75
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• 2012

Purpose: It is important to acquire accurate data because the SPECT scan affected by various physical factors. The aim of this study was to compare the uniformity when both centers were matched or mismatched differed from position of heart in COR. Materials and methods: The images were acquired with cylindrical uniform phantom (6.7 cm diameter, 9 cm length) and heart insert phantom using Cardio MD SPECT system (Philips, USA). The phantoms were positioned on COR as well as four different points which were 10 cm above, below, left and right side from the COR. The counts from the both edge of cylindrical uniform phantom and those from the both wall of heart insert phantom were compared by using vertical and horizontal line profile. In addition, the qualitative evaluation was performed with heart insert phantom images and volunteer test. Results: In heart insert phantom study, the differences of counts between COR and 10 cm above, below, left and right point of COR were 1.1, 4.1, 4.9, 2.2 and 0.9% using T-A curve for horizontal view. In case of vertical view of COR 3.9, 21.9, 3.5, 23.9, 14.0% were shown. In cylindrical phantom study, the differences of counts between COR and 10 cm above, below, left and right point of COR were 4.3, 0.3, 3.3, 2.6 and 0.7% using T-A curve for horizontal view. In case of vertical view of COR 2.7, 3.0, 1.0, 0.3, 3.4% were shown. For qualitative evaluation, the images at COR were the most uniform for both of heart insert phantom and volunteer test, whereas other four positions showed somewhat distorted images. Conclusion: It showed the most uniform images when COR is matched with the heart. Therefore, we can expect that distortion which increased or decreased of myocardial perfusion will be prevented by matching the heart and COR when positioning. Furthermore, the accuracy of diagnosis will be improved as well.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.3
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• pp.259-260
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• 2008

Tetrofosmin is a ligand that forms a lipophilic, cationic complex with Tc-99m. Tc-99m tetrofosmin was developed as a myocardial perfusion imaging agent and also used to depict tumors. Mediastinal tumors is also detected by Tc-99m tetrofosmin. We report a case of extracardiac mediastinal activity detected by Tc-99m tetrofosmin scintigraphy, which revealed thymoma.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.2
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• pp.80-85
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• 2017

Purpose The D530c have cadmium zinc telluride(CZT) detectors that are arranged focus on the heart. This structural characteristic allows for quicker imaging without rotation, but this is sensitive to patient movement and can affect the test results. The aim of this study is to optimize the image quality by reducing patient movement during the examination. Materials and Methods We analyzed the patients' movements, and performed various activities such as provided patient education about correct breathing techniques and avoiding patient movements, and created breathing correction tools to minimize patient movement during exam. The 70 patients who underwent myocardial perfusion SPECT with D530c in November 2016 were categorized as the group before the corrective steps. Another 70 patients who underwent the procedure with D530c from February 14, 2017 to February 21, 2017 were categorized as the improvement group. Images acquired during stress and at rest were compared and analyzed by measuring the durations of heart movements over certain distances (4 mm, 8 mm, 12 mm, or more) noted on the x-, y-, and zaxes. Results After the activities, the durations of heart movements decreased in the images acquired both under stress and at rest. In particular, there were no large motions greater than 12 mm recorded in the stress images after the improvement. There was a significant difference (p<0.005) in the 4-mm and 8-mm fluctuations on the X-axis and the 8-mm fluctuations on the Z axis in the stress images, but there was no significant difference (p>0.005) in the other stress and rest intervals. Conclusion The decrease in the time of motion occurrence due to the 4 mm fluctuation distance that can occur through breathing can be understood as a result of the breathing being corrected through training and motion prevention tools. It is expected that the image quality will be improved by reducing the occurrence time according to the variation distance of 8 mm or 12 mm, which is expected as the actual movement of the patient other than the breathing.

• Progress in Medical Physics
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• v.22 no.1
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• pp.42-51
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• 2011

Nuclear medicine images (SPECT, PET) were widely used tool for assessment of myocardial viability and perfusion. However it had difficult to define accurate myocardial infarct region. The purpose of this study was to investigate methodological approach for automatic measurement of rat myocardial infarct size using polar map with adaptive threshold. Rat myocardial infarction model was induced by ligation of the left circumflex artery. PET images were obtained after intravenous injection of 37 MBq $^{18}F$-FDG. After 60 min uptake, each animal was scanned for 20 min with ECG gating. PET data were reconstructed using ordered subset expectation maximization (OSEM) 2D. To automatically make the myocardial contour and generate polar map, we used QGS software (Cedars-Sinai Medical Center). The reference infarct size was defined by infarction area percentage of the total left myocardium using TTC staining. We used three threshold methods (predefined threshold, Otsu and Multi Gaussian mixture model; MGMM). Predefined threshold method was commonly used in other studies. We applied threshold value form 10% to 90% in step of 10%. Otsu algorithm calculated threshold with the maximum between class variance. MGMM method estimated the distribution of image intensity using multiple Gaussian mixture models (MGMM2, ${\cdots}$ MGMM5) and calculated adaptive threshold. The infarct size in polar map was calculated as the percentage of lower threshold area in polar map from the total polar map area. The measured infarct size using different threshold methods was evaluated by comparison with reference infarct size. The mean difference between with polar map defect size by predefined thresholds (20%, 30%, and 40%) and reference infarct size were $7.04{\pm}3.44%$, $3.87{\pm}2.09%$ and $2.15{\pm}2.07%$, respectively. Otsu verse reference infarct size was $3.56{\pm}4.16%$. MGMM methods verse reference infarct size was $2.29{\pm}1.94%$. The predefined threshold (30%) showed the smallest mean difference with reference infarct size. However, MGMM was more accurate than predefined threshold in under 10% reference infarct size case (MGMM: 0.006%, predefined threshold: 0.59%). In this study, we was to evaluate myocardial infarct size in polar map using multiple Gaussian mixture model. MGMM method was provide adaptive threshold in each subject and will be a useful for automatic measurement of infarct size.