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The Alignment Evaluation for Patient Positioning System(PPS) of Gamma Knife PerfexionTM (감마나이프 퍼펙션의 자동환자이송장치에 대한 정렬됨 평가)

  • Jin, Seong Jin;Kim, Gyeong Rip;Hur, Beong Ik
    • Journal of the Korean Society of Radiology
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    • v.14 no.3
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    • pp.203-209
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    • 2020
  • The purpose of this study is to assess the mechanical stability and alignment of the patient positioning system (PPS) of Leksell Gamma Knife Perfexion(LGK PFX). The alignment of the PPS of the LGK PFX was evaluated through measurements of the deviation of the coincidence of the Radiological Focus Point(RFP) and the PPS Calibration Center Point(CCP) applying different weights on the couch(0, 50, 60, 70, 80, and 90 kg). In measurements, a service diode test tool with three diode detectors being used biannually at the time of the routine preventive maintenance was used. The test conducted with varying weights on the PPS using the service diode test tool measured the radial deviations for all three collimators 4, 8, and 16 mm and also for three different positions of the PPS. In order to evaluate the alignment of the PPS, the radial deviations of the correspondence of the radiation focus and the LGK calibration center point of multiple beams were averaged using the calibrated service diode test tool at three university hospitals in Busan and Gyeongnam. Looking at the center diode for all collimators 4, 8, and 16 mm without weight on the PPS, and examining the short and long diodes for the 4 mm collimator, the means of the validation difference, i.e., the radial deviation for the setting of 4, 8, and 16 mm collimators for the center diode were respectively measured to 0.058 ± 0.023, 0.079 ± 0.023, and 0.097 ± 0.049 mm, and when the 4 mm collimator was applied to the center diode, the short diode, and the long diode, the average of the radial deviation was respectively 0.058 ± 0.023, 0.078 ± 0.01 and 0.070 ± 0.023 mm. The average of the radial deviations when irradiating 8 and 16 mm collimators on short and long diodes without weight are measured to 0.07 ± 0.003(8 mm sd), 0.153 ± 0.002 mm(16 mm sd) and 0.031 ± 0.014(8 mm ld), 0.175 ± 0.01 mm(16 mm ld) respectively. When various weights of 50 to 90 kg are placed on the PPS, the average of radial deviation when irradiated to the center diode for 4, 8, and 16 mm is 0.061 ± 0.041 to 0.075 ± 0.015, 0.023 ± 0.004 to 0.034 ± 0.003, and 0.158 ± 0.08 to 0.17 ± 0.043 mm, respectively. In addition, in the same situation, when the short diode for 4, 8, and 16 mm was irradiated, the averages of radial deviations were 0.063 ± 0.024 to 0.07 ± 0.017, 0.037 ± 0.006 to 0.059 ± 0.001, and 0.154 ± 0.03 to 0.165 ± 0.07 mm, respectively. In addition, when irradiated on long diode for 4, 8, and 16 mm, the averages of radial deviations were measured to be 0.102 ± 0.029 to 0.124 ± 0.036, 0.035 ± 0.004 to 0.054 ± 0.02, and 0.183 ± 0.092 to 0.202 ± 0.012 mm, respectively. It was confirmed that all the verification results performed were in accordance with the manufacturer's allowable deviation criteria. It was found that weight dependence was negligible as a result of measuring the alignment according to various weights placed on the PPS that mimics the actual treatment environment. In particular, no further adjustment or recalibration of the PPS was required during the verification. It has been confirmed that the verification test of the PPS according to various weights is suitable for normal Quality Assurance of LGK PFX.

Clinical Features of Acute Nonspecific Mesenteric Lymphadenitis and Factors for Differential Diagnosis with Acute Appendicitis (급성 비특이성 장간막 림프절염의 임상 소견과 급성 충수돌기염과의 감별 인자)

  • Shin, Kyung Hwa;Kim, Gab Cheol;Lee, Jung Kwon;Lee, Young Hwan;Kam, Sin;Hwang, Jin Bok
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.31-39
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    • 2004
  • Purpose: Although acute nonspecific mesenteric lymphadenitis (ANML) is probably common cause of abdominal pain in children, which can be severe enough to be an abdominal emergency, the clinical features of mesenteric lymphadenitis are not clear. Also, a differential diagnosis with acute appendicitis (APPE) is indispensable to avoid serious complications. The clinical features of ANML were determined, and the risk factors for differential diagnosis with APPE were analyzed. Methods: Between November 2000 and May 2001, data from 26 patients (aged 1 to 11 years) with ANML and 21 patients (aged 2 to 13 years) with APPE were reviewed. ANML was defined as a cluster of five or more lymph nodes measuring 10 mm or greater in their longitudinal diameter in the right lower quadrant (RLQ) without an identifiable specific inflammatory process on the ultrasonographic examination. There were risk factors on patient's history, physical examination, and laboratory examination; the location of abdominal pain, abdominal rigidity, rebound tenderness, fever, nocturnal pain, the vomiting intensity, the diarrhea intensity, the symptom duration, and the peripheral blood leukocytes count. Results: Of the 26 ANML patients and 21 APPE patients, abdominal pain was noted on periumbilical (76.9% vs 14.2%), on RLQ (11.5% vs 71.4%), with abdomen rigidity (7.6% vs 80.9%), with rebound tenderness (0.0% vs 76.1%)(p<0.05), in the lower abdomen (11.5% vs 14.2%), and at night (80.8% vs 100.0%) (p>0.05). The clinical symptoms were vomiting (38.4% vs 90.4%), the vomiting intensity ($1.5{\pm}0.7$ [1~3]/day vs $4.5{\pm}2.9$ [1~10]/day), diarrhea (65.3% vs 28.5%) (p<0.05), and fever (61.5% vs 76.2%)(p>0.05). The period to the subsidence of abdominal pain in the ANMA patients was $2.5{\pm}0.5$ (2~3) days. The laboratory data showed a significant difference in the peripheral blood leukocytes count ($8,403{\pm}1,737[5,900{\sim}12,300]/mm^3\;vs\;15,471{\pm}3,749[5,400{\sim}20,800]/mm^3$)(p<0.05). Discriminant analysis between ANML and APPE showed that the independent discriminant factors were a vomiting intensity and the peripheral blood leukocytes count and the discriminant power was 95.7%. Conclusion: The clinical characteristics of ANML were abrupt onset of periumbilical pain without rigidity or rebound tenderness, a mild vomiting intensity, normal peripheral leukocytes count, and relatively short clinical course. If the abdominal pain persist for more than 3 days, and/or the vomiting intensity is more than 3 times/day, and/or the peripheral leukocytes count is over $13,500/mm^3$, abdominal ultrasonography is recommended to rule out APPE.

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Clinical Observations of Gastrointestinal Cow Milk Allergy in Children According to a New Classification (새로운 분류법에 따른 소아 위장관 우유 알레르기 질환에 관한 임상적 고찰)

  • Hwang, Jin Bok;Choi, Seon Yun;Kwon, Tae Chan;Oh, Hoon Kyu;Kam, Sin
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.7 no.1
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    • pp.40-47
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    • 2004
  • Purpose: A new classification of gastrointestinal food allergy was published, but the changes of terminology between previously reported terms and the new ones were in a state of disorder. This has resulted in confusion between medical communication and diagnostic and therapeutic approaches. The clinical observations of infants presenting with gastrointestinal cow milk allergy (GI-CMA) were performed, and the changes in the terminology reviewed through the published Korean literature. Methods: Between March 2003 and July 2003, data from 37 consecutive infants with GI-CMA, aged 2 weeks to 15 months, were reviewed. The challenge and elimination test of cow milk, and the endoscopic and histologic findings, were used for the seven subdivisions of GI-CMA according to a new classification on the basis of patients' ages, clinical manifestations and location of gastrointestinal lesions. Results: The 37 patients had a mean age of $5.4{\pm}4.8$ months, with those observed in 26 (70.3%) of patients being below 6 months of age. The seven final diagnoses were; cow milk protein-induced enterocolitis (CMPIE) in 12 (32.4%), cow milk protein proctitis (PROC) in 12 (32.4%), IgE-mediated (IGE) in 6 (16.2%), gastroesophageal reflux-associated cow milk allergy (GERA) in 5 (13.5%) and eosinophilic gastroenterocolitis in 2 (5.4%). CMPIE was revealed as the typical type in 7 (18.9%) and the atypical type in 5 (13.5%), and all of typical CMPIE revealed cow milk protein-induced enteropathy. The mean age at symptom onset was $4.3{\pm}0.8$ months, and for those with typical and atypical CMPIE, and PROC and GERA were $3.8{\pm}4.6$, $10.4{\pm}3.8$, $3.4{\pm}3.9$ and $7.8{\pm}5.7$ months, respectively (p<0.05). The period from onset of symptom to diagnosis was $2.4{\pm}3.3$ (0.5~12) months, with those observed in atypical CMPIE and GERA being over 3months. Although the birth weights in all patients were within the 10~90 percentile range, the body weights on diagnoses were below the 3 percentile in 48.6%; IGE 16.7%, EOS 0%, typical CMPIE 85.7%, atypical CMPIE 60.0%, PROC 25.0% and GERA 100% (p<0.05). Through the review of the Korean literature, 8 case reports and 14 original articles for GI-CMA were found. Conclusion: GI-CMA is not a rare clinical disorder and is subdivided into seven categories on the basis of the patient's age, clinical manifestations and location of the gastrointestinal lesions. The terms for GI-CMA are changing with new classifications, and careful approaches are necessary for medical communications.

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The Role of Control Transparency and Outcome Feedback on Security Protection in Online Banking (계좌 이용 과정과 결과의 투명성이 온라인 뱅킹 이용자의 보안 인식에 미치는 영향)

  • Lee, Un-Kon;Choi, Ji Eun;Lee, Ho Geun
    • Information Systems Review
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    • v.14 no.3
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    • pp.75-97
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    • 2012
  • Fostering trusting belief in financial transactions is a challenging task in Internet banking services. Authenticated Certificate had been regarded as an effective method to guarantee the trusting belief for online transactions. However, previous research claimed that this method has some loopholes for such abusers as hackers, who intend to attack the financial accounts of innocent transactors in Internet. Two types of methods have been suggested as alternatives for securing user identification and activity in online financial services. Control transparency uses information over the transaction process to verify and to control the transactions. Outcome feedback, which refers to the specific information about exchange outcomes, provides information over final transaction results. By using these two methods, financial service providers can send signals to involved parties about the robustness of their security mechanisms. These two methods-control transparency and outcome feedback-have been widely used in the IS field to enhance the quality of IS services. In this research, we intend to verify that these two methods can also be used to reduce risks and to increase the security protections in online banking services. The purpose of this paper is to empirically test the effects of the control transparency and the outcome feedback on the risk perceptions in Internet banking services. Our assumption is that these two methods-control transparency and outcome feedback-can reduce perceived risks involved with online financial transactions, while increasing perceived trust over financial service providers. These changes in user attitudes can increase the level of user satisfactions, which may lead to the increased user loyalty as well as users' willingness to pay for the financial transactions. Previous research in IS suggested that the increased level of transparency on the process and the result of transactions can enhance the information quality and decision quality of IS users. Transparency helps IS users to acquire the information needed to control the transaction counterpart and thus to complete transaction successfully. It is also argued that transparency can reduce the perceived transaction risks in IS usage. Many IS researchers also argued that the trust can be generated by the institutional mechanisms. Trusting belief refers to the truster's belief for the trustee to have attributes for being beneficial to the truster. Institution-based trust plays an important role to enhance the probability of achieving a successful outcome. When a transactor regards the conditions crucial for the transaction success, he or she considers the condition providers as trustful, and thus eventually trust the others involved with such condition providers. In this process, transparency helps the transactor complete the transaction successfully. Through the investigation of these studies, we expect that the control transparency and outcome feedback can reduce the risk perception on transaction and enhance the trust with the service provider. Based on a theoretical framework of transparency and institution-based trust, we propose and test a research model by evaluating research hypotheses. We have conducted a laboratory experiment in order to validate our research model. Since the transparency artifact(control transparency and outcome feedback) is not yet adopted in online banking services, the general survey method could not be employed to verify our research model. We collected data from 138 experiment subjects who had experiences with online banking services. PLS is used to analyze the experiment data. The measurement model confirms that our data set has appropriate convergent and discriminant validity. The results of testing the structural model indicate that control transparency significantly enhances the trust and significantly reduces the risk perception of online banking users. The result also suggested that the outcome feedback significantly enhances the trust of users. We have found that the reduced risk and the increased trust level significantly improve the level of service satisfaction. The increased satisfaction finally leads to the increased loyalty and willingness to pay for the financial services.

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The Magnetic Relaxation Properties of DTPA-bis(4-carboxycyclohexyl) amide Paramagnetic Gd-chelates (DTPA-bis(4-carboxycyclohexyl)amide 상자성 복합체의 자기이완특성에 관한 연구)

  • Kim, In-Sung;Lee, Young-Ju;Lee, Jae-Jun;Kim, Ju-Hyun;Kim, Yoo-Kyung;Sujit, Dutta;Kim, Suk-Kyung;Kim, Tae-Jeong;Kang, Duk-Sik;Chang, Yong-Min
    • Investigative Magnetic Resonance Imaging
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    • v.10 no.1
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    • pp.20-25
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    • 2006
  • Purpose : To evaluate the NMR relaxation properties of newly developed high performance paramagnetic complexes. Materials and methods : 4-aminomethylcyclohexane carboxylic acid (0.63g, 4 mmol) was mixed with the suspension solution of DMF (15mL) and DTPA-bis-anhydride (0.71g, 2 mmol) to synthesize the ligand. The ligand was then mixed with Gd2O3 (0.18g, 0.5 mmol) to synthesize Gd-chelate. For the measurement of magnetic relaxivity of paramagnetic compounds, the compounds were diluted to 1mM and then the relaxation times were measured at 1.5T(64 MHz). Inversion-recovery pulse sequence was employed for T1 relaxation measurement and CPMG(Carr-Purcell-Meiboon-Gill) pulse sequence was employed for T2 relaxation measurement. Using MATLAB(Version 7.1) program, T1 magnetic relaxation map, R1 map, T2 magnetic relaxation map and R2 map were developed to represent magnetic relaxation time and magnetic relaxivity as image. Results : Compared to $R1=4.9mM^{-1}sec^{-1}$ and $R2=4.8mM^{-1}sec^{-1}$ of Omniscan (Gadodiamide), which is commercially available paramagnetic MR agent, R1 of SUK090(Gd-C32H74N5O24) was $12.46mM^{-1}sec^{-1}$ and R1 of SUK091(Gd-C34H78N5O24) was $12.77mM^{-1}sec^{-1}$. However, R1 of SUK092(Gd-C30H56N5O17) was decreased to $2.09mM^{-1}sec^{-1}$. In case of R2, SUK090(Gd-C32H74N5O24) was $8.76mM^{-1}sec^{-1}$ and SUK091(Gd-C34H78N5O24) was $7.60mM^{-}1sec^{-1}$ whereas SUK092(Gd-C30H56N5O17) was decreased to $1.82mM^{-1}sec^{-1}$. Conclusion : Among three new paramagnetic complexes, SUK090(Gd-C32H74N5O24) and SUK091(Gd-C34H78N5O24) showed higher T1, T2 magnetic relaxation rates than that of commercially available paramagnetic MR agent and thus expected to have more contrast enhancement effect.

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A Study on Preparation of 3'-$[^{18}F]$Fluoro-3'-deoxythymidine and Its Biodistribution in 9L Glioma Bearing Rats (3'-$[^{18}F]$Fluoro-3'-deoxythymidine의 합성과 9L glioma 세포를 이식한 래트에서의 체내동태에 관한 연구)

  • Shim, Ah-Young;Moon, Byung-Seok;Lee, Tae-Sup;Lee, Kyo-Chul;An, Gwang-Il;Yang, Seung-Dae;Yu, Kook-Hyun;Cheon, Gi-Jeong;Choi, Chang-Woon;Lim, Sang-Moo;Chun, Kwon-Soo
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.5
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    • pp.263-270
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    • 2006
  • Purpose: Several radioisotope-labeled thymidine derivatives such as $[^{11}C]$thymidine was developed to demonstrate cell proliferation in tumor. But it is difficult to track metabolism with $[^{11}C]$thymidine due to rapid in vivo degradation and its short physical half-life. 3'-$[^{18}F]$fluoro-3'-deoxythymidine ($[^{18}F]$FLT) was reported to have the longer half life of fluorine-18 and the lack of metabolic degradation in vivo. Here, we described the synthesis of the 3'-$[^{18}F]$fluoro-3'-deoxythymidine ($[^{18}F]$FLT) and compared with $([^{18}F]FET)\;and\;([^{18}F]FDG)$ in cultured 9L cell and obtained the biodistribution and PET image in 9L tumor hearing rats. Material and Methods: For the synthesis of $[^{18}F]$FLT, 3-N-tert-butoxycarbonyl-(5'-O-(4,4'-dimet hoxytriphenylmethyl)-2'-deoxy-3'-O-(4-nitrobenzenesulfonyl)-${\beta}$-D-threopentofuranosyl)thymine was used as a FLT precursor, on which the tert-butyloxycarbonyl group was introduced to protect N3-position and nitrobenzenesulfonyl group. Radiolabeling of nosyl substitued precursor with $^{18}F$ was performed in acetonitrile at $120^{\circ}C$ and deproteced with 0.5 N HCI. The cell uptake was measured in cultured 9L glioma cell. The biodistribution was evaluated in 9L tumor bearing rats after intravenous injection at 10 min, 30 min, 60 min and 120 min and obtained PET image 60 minutes after injection. Results: The radiochemical yield was about 20-30% and radiochemical purity was more than 95% after HPLC purification. Cellular uptake of $[^{18}F]$FLT was increased as time elapsed. At 120 min post-injection, the ratios of tumor/blood, tumor/muscle and tumor/brain were $1.61{\pm}0.34,\;1.70{\pm}0.30\;and\;9.33{\pm}2.22$, respectively. The 9L tumor was well visualized at 60 min post injection in PET image. Conclusion: The uptake of $[^{18}F]$FLT in tumor was higher than in normal brain and PET image of $[^{18}F]$FLT was acceptable. These results suggest the possibility of $[^{18}F]$FLT at an imaging agent for brain tumor.

Performance Evaluation of Siemens CTI ECAT EXACT 47 Scanner Using NEMA NU2-2001 (NEMA NU2-2001을 이용한 Siemens CTI ECAT EXACT 47 스캐너의 표준 성능 평가)

  • Kim, Jin-Su;Lee, Jae-Sung;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.38 no.3
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    • pp.259-267
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    • 2004
  • Purpose: NEMA NU2-2001 was proposed as a new standard for performance evaluation of whole body PET scanners. in this study, system performance of Siemens CTI ECAT EXACT 47 PET scanner including spatial resolution, sensitivity, scatter fraction, and count rate performance in 2D and 3D mode was evaluated using this new standard method. Methods: ECAT EXACT 47 is a BGO crystal based PET scanner and covers an axial field of view (FOV) of 16.2 cm. Retractable septa allow 2D and 3D data acquisition. All the PET data were acquired according to the NEMA NU2-2001 protocols (coincidence window: 12 ns, energy window: $250{\sim}650$ keV). For the spatial resolution measurement, F-18 point source was placed at the center of the axial FOV((a) x=0, and y=1, (b)x=0, and y=10, (c)x=70, and y=0cm) and a position one fourth of the axial FOV from the center ((a) x=0, and y=1, (b)x=0, and y=10, (c)x=10, and y=0cm). In this case, x and y are transaxial horizontal and vertical, and z is the scanner's axial direction. Images were reconstructed using FBP with ramp filter without any post processing. To measure the system sensitivity, NEMA sensitivity phantom filled with F-18 solution and surrounded by $1{\sim}5$ aluminum sleeves were scanned at the center of transaxial FOV and 10 cm offset from the center. Attenuation free values of sensitivity wire estimated by extrapolating data to the zero wall thickness. NEMA scatter phantom with length of 70 cm was filled with F-18 or C-11solution (2D: 2,900 MBq, 3D: 407 MBq), and coincidence count rates wire measured for 7 half-lives to obtain noise equivalent count rate (MECR) and scatter fraction. We confirmed that dead time loss of the last flame were below 1%. Scatter fraction was estimated by averaging the true to background (staffer+random) ratios of last 3 frames in which the fractions of random rate art negligibly small. Results: Axial and transverse resolutions at 1cm offset from the center were 0.62 and 0.66 cm (FBP in 2D and 3D), and 0.67 and 0.69 cm (FBP in 2D and 3D). Axial, transverse radial, and transverse tangential resolutions at 10cm offset from the center were 0.72 and 0.68 cm (FBP in 2D and 3D), 0.63 and 0.66 cm (FBP in 2D and 3D), and 0.72 and 0.66 cm (FBP in 2D and 3D). Sensitivity values were 708.6 (2D), 2931.3 (3D) counts/sec/MBq at the center and 728.7 (2D, 3398.2 (3D) counts/sec/MBq at 10 cm offset from the center. Scatter fractions were 0.19 (2D) and 0.49 (3D). Peak true count rate and NECR were 64.0 kcps at 40.1 kBq/mL and 49.6 kcps at 40.1 kBq/mL in 2D and 53.7 kcps at 4.76 kBq/mL and 26.4 kcps at 4.47 kBq/mL in 3D. Conclusion: Information about the performance of CTI ECAT EXACT 47 PET scanner reported in this study will be useful for the quantitative analysis of data and determination of optimal image acquisition protocols using this widely used scanner for clinical and research purposes.

Evaluation of Multiple System Atrophy and Early Parkinson's Disease Using $^{123)I$-FP-CIT SPECT ($^{123)I$-FP-CIT SPECT를 이용한 다중계위축증 및 조기 파킨슨병에서의 평가)

  • Oh, So-Won;Kim, Yu-Kyeong;Lee, Byung-Chul;Kim, Bom-Sahn;Kim, Ji-Sun;Kim, Jong-Min;Kim, Sang-Eun
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.1
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    • pp.10-18
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    • 2009
  • Purpose: We investigated quantification of dopaminergic transporter (DAT) and serotonergic transporter (SERT) on $^{123}I$-FP-CIT SPECT for differentiating between multiple systemic atrophy (MSA) and idiopathic Parkinson's disease (IPD). Materials and Methods: N-fluoropropyl-$2{\beta}$-carbomethoxy-$3{\beta}$-4-[$^{123}I$]-iodophenylnortropane SPECT ($^{123}I$-FP-CIT SPECT) was performed in 8 patients with MSA (mean age: $64.0{\pm}4.5yrs$, m:f=6:2), 13 with early IPD (mean age: $65.5{\pm}5.3yrs$, m:f=9:4), and 12 healthy controls (mean age: $63.3{\pm}5.7yrs$, m:f=8:4). Standard regions of interests (ROls) of striatum to evaluate DAT, and hypothalamus and midbrain for SERT were drawn on standard template images and applied to each image taken 4 hours after radiotracer injection. Striatal specific binding for DAT and hypothalamic and midbrain specific binding for SERT were calculated using region/reference ratio based on the transient equilibrium method. Group differences were tested using ANOVA with the postHoc analysis. Results: DAT in the whole striatum and striatal subregions were significantly decreased in both patient groups with MSA and early IPD, compared with healthy control (p<0.05 in all). In early IPD, a significant increase in the uptake ratio in anterior and posterior putamen and a trend of increase in caudate to putamen ratio was observed. In MSA, the decrease of DAT was accompanied with no difference in the striatal uptake pattern compared with healthy controls. Regarding the brain regions where $^{123}I$-FP-CIT binding was predominant by SERT, MSA patients showed a decrease in the binding of $^{123}I$-FP-CIT in the pons compared with controls as well as early IPD patients (MSA: $0.22{\pm}0.1$ healthy controls: $0.33{\pm}0.19$, IPD: $0.29{\pm}0.19$), however, it did not reach the statistical significance. Conclusion: In this study, the differential patterns in the reduction of DAT in the striatum and the reduction of pontine $^{123}I$-FP-CIT binding predominant by SERT could be observed in MSA patients on $^{123}I$-FP-CIT SPECT. We suggest that the quantification of SERT as well as DAT using $^{123}I$-FP-CIT SPECT is helpful to differentiate parkinsonian disorders in early stage.

Effect of the Angle of Ventricular Septal Wall on Left Anterior Oblique View in Multi-Gated Cardiac Blood Pool Scan (게이트 심장 혈액풀 스캔에서 심실중격 각도에 따른 좌전사위상 변화에 대한 연구)

  • You, Yeon Wook;Lee, Chung Wun;Seo, Yeong Deok;Choi, Ho Yong;Kim, Yun Cheol;Kim, Yong Geun;Won, Woo Jae;Bang, Ji-In;Lee, Soo Jin;Kim, Tae-Sung
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.1
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    • pp.13-19
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    • 2016
  • Purpose In order to calculate the left ventricular ejection fraction (LVEF) accurately, it is important to acquire the best septal view of left ventricle in the multi-gated cardiac blood pool scan (GBP). This study aims to acquire the best septal view by measuring angle of ventricular septal wall (${\theta}$) using enhanced CT scan and compare with conventional method using left anterior oblique (LAO) 45 view. Materials and Methods From March to July in 2015, we analyzed the 253 patients who underwent both enhanced chest CT and GBP scan in the department of nuclear medicine at National Cancer Center. Angle (${\theta}$) between ventricular septum and imaginary midline was measured in transverse image of enhanced chest CT scan, and the patients whose difference between the angle of ${\theta}$ and 45 degree was more than 10 degrees were included. GBP scan was acquired using both LAO 45 and LAO ${\theta}$ views, and LVEFs measured by automated and manual region of interest (Auto-ROI and Manual-ROI) modes respectively were analyzed. Results $Mean{\pm}SD$ of ${\theta}$ on total 253 patients was $37.0{\pm}8.5^{\circ}$. Among them, the patients whose difference between 45 and ${\theta}$ degrees were more than ${\pm}10$ degrees were 88 patients ($29.3{\pm}6.1^{\circ}$). In Auto-ROI mode, there was statistically significant difference between LAO 45 and LAO ${\theta}$ (LVEF $45=62.0{\pm}6.6%$ vs. LVEF ${\theta}=64.0{\pm}5.6%$; P = 0.001). In Manual-ROI mode, there was also statistically significant difference between LAO 45 and LAO ${\theta}$ (LVEF $45=66.7{\pm}7.2%$ vs. LVEF ${\theta}=69.0{\pm}6.4%$; P < 0.001). Intraclass correlation coefficients of both methods were more than 95%. In case of comparison between Auto-ROI and Manual ROI of each LAO 45 and LAO ${\theta}$, there was no significant difference statistically. Conclusion We could measure the angle of ventricular septal wall accurately by using transverse image of enhanced chest CT and applied to LAO acquisition in the GBP scan. It might be the alternative method to acquire the best septal view of LAO effectively. We could notify significant difference between conventional LAO 45 and LAO ${\theta}$ view.

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Study on the Evaluation of Renal Function According to Set a Partial Region of Interest in 99mTc-DMSA scan of the Pediatric Patient with a Duplicated Ureter (중복요관을 가진 소아환자의 99mTc-DMSA 검사에서 부분적 관심영역 설정에 따른 신기능 평가에 관한 연구)

  • Nam-Koong, Hyuk;Oh, Shin Hyun;Kim, Jung Yul;Choi, Yoon Jung;Kim, Jae Sam;Lee, Chang Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.17 no.1
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    • pp.43-47
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    • 2013
  • Purpose: A duplicated ureter is congenital renal malformations with ureter in two. Patients with duplicated ureter are in force to $^{99m}Tc-DMSA$ scan at surgery before and after. In existing examination, at produce result after $^{99m}Tc-DMSA$ scan, didn't compare to upper pole and lower pole with malformed kidney and compared to only relative uptake ratio. Therefore, this study will examine about utility of set a partial region of interest and to functional recovery of renal cell through change of upper pole uptake ratio of malformed kidney by setting each partial region of interest in upper pole and lower pole of malformed kidney in $^{99m}Tc-DMSA$ examination in surgery before and after. Materials and Methods: Pediatric patients with malformed kidney of incomplete duplicated ureter, 15 patients were enrolled in this study. Scanning were scan 3 to 4 hours after injection of $^{99m}Tc-DMSA$ 1.5 ~ 1.9 MBq/kg. Region of interest were each set in normal kidney, upper pole and lower pole with malformed kidney. Region of interest were set with same condition and method to images of surgery before and after that radio technologist 1 person, resident of nuclear medicine 1 person and doctor of urology together. Therefore, this study were compared to uptake ratio (A: B: C) that normal kidney (A), lower pole of malformed kidney (B) and upper pole of malformed kidney (C) about uptake ratio changes of malformed kidney in follow-up examination of surgery before and after. Results: When compared to 15 patients, uptake ratios were increased 7 persons and decreased 8 persons. Among increased 7 persons, it were periods of follow-up examination that 2 persons were 14 months, 4 persons were 12 months and 1 person was 8 months after surgery. Among decreased 8 persons, it were periods of follow-up examination that 4 persons were 12 months 3 persons were 6 months and 1 persons were 4 months after surgery. Conclusion: Existing study could not see the exact uptake ratio changes of malformed kidney because using only the overall Left-Right kidney uptake ratios. But a setting partial region of interest was able to see exactly what changes in the uptake of each upper pole and lower pole of malformed kidney. Because recovery of renal parenchymal cells is difficult in an evaluation of short period of time, follow-up examination should be made in long period of time. How to set up partial region of interest be thought that it would be useful.

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