Comparison of Radioactivity Measurement with Radionuclide Calibrators in Nuclear Medicine Centers / 의학물리

To acquire good image quality and to minimize unnecessary radiation dose to patients, it is important to ensure that the radiopharmaceutical administered is accurately measured. Quality control of radionuclide calibrators should be performed to achieve these goals. The purpose of this study is to support the quality control of radionuclide calibrators in nuclear medicine centers and to investigate the level of measurement accuracy of the radionuclide calibrators. 58 radionuclide calibrators from 45 nuclear medicine centers, 74 radionuclide calibrators from 58 nuclear medicine centers, and 60 radionuclide calibrators from 45 nuclear medicine centers were tested with I-131, Tc-99m and I-123, respectively. The results showed that 81% of calibrators for I-131, 61% of calibrators for Tc-99m and 67% of calibrators for I-123 were within +/-5%. 17% of calibrators for I-131, 20% of calibrators for Tc-99m and 15% of calibrators for I-123 had a deviation in the range 5%10%. Follow-up measurements were performed on the calibrators whose error exceeded the +/-10% limit. As a result, some of the calibrator showed an improvement and their deviation decreased below the +/-10% limit. The results have shown that such comparisons are necessary to improve the accuracy of the measurement and to identify malfunctioning radionuclide calibrators.

Impact of Contrast Agent for PET Images with CT-based Attenuation Correction / 의학물리

Experiments and simulation were done to study the impact of contrast agent when CT scan was used to attenuation correction for PET images in PET/CT system. Whole body phantom was imaged with various concentration of iodine-based contrast agent using CT. Mathematical emission and transmission density map with liver were made to simulate for whole body FDG imaging. A variety of factors were estimated, including non-uniform enhancement of contrast agent, concentration and distribution size of contrast agent, noise level, image resolution, reconstruction algorithm, hypo-attenuation of contrast agent, and different time phases for contrast agent. Experimental studies showed that Hounsfield unit depends on the concentration of contrast agent and tube voltage. From the simulation data, contrast agents introduced artifacts and degraded image quality on the attenuation-corrected PET images. The severity of these effects depends on a variety of factors, including the concentration and distribution size of contrast agent, the noise levels, and the image resolution. These results indicated that the impact of contrast agents should be considered with a full understanding of their potential problems in clinical PET/CT images.

Improved Scatter Correction for SPECT Images: A Monte Carlo Simulation Study / 대한핵의학회잡지

PURPOSE: Abutted scatter energy windows used for a triple energy window (TEW) method may provide wrong estimation of scatter. This study is to propose an extended TEW (ETEW) method, which doesn't require abutted scatter energy windows and overcomes the shortcomings of TEW method. MATERIALS AND METHODS: The ETEW is a modification of the TEW which corrects for scatter by using abutted scatter rejection windows, which can overestimate or underestimate scatter. The ETEW is compared to the TEW using Monte Carlo simulated data for point sources as well as hot and cold spheres in a cylindrical water phantom. Various main energy window widths (10 %, 15 % and 20 %) were simulated. Both TEW and ETEW improved image contrast, % recovery coefficients and normalized standard deviation. RESULTS: Both of TEW and ETEW improved image contrast and % recovery coefficients. Estimated scatter components by the TEW were not proportional to the true scatter components over the main energy windows when ones of 10 %, 15 %, and 20 % were simulated. The ETEW linearly estimated scatter components over the width of the main energy windows. CONCLUSION: We extended the TEW method into the method which could linearly estimate scatter components over the main energy windows.

Evaluation of a Conjugate View Method for Determination of Kidney Uptake / 대한핵의학회잡지

PURPOSE: In order to obtain better quantitation of kidney uptake, this study is to evaluate a conjugate view method (CVM) using a geometric mean attenuation correction for kidney uptake and to compare it to Gate's method. MATERIALS AND METHODS: We used a Monte Carlo code, SIMIND and a Zubal phantom, to simulate kidney uptake. SIMIND was both simulated with or without scatter for the Zubal phantom. Also, a real phantom test was carried out using a dual-head gamma camera. The activity of 0.5 mCi was infused into two small cylinder phantoms of 5 cm diameter, and then, they were inserted into a cylinder phantom of 20 cm diameter. The results by the CVM method were compared with ideal data without both of attenuation and scatter and with Gate's method. The CVM was performed with or without scatter correction. The Gate's method was performed without scatter correction and it was evaluated with regards to 0.12 cm (-1) and 0.15 cm (-1) attenuation coefficients. Data were analyzed with comparisons of mean counts in the regions of interest (ROI), profiles drawn over kidney images and linear regression. Correlation coefficients were calculated with ideal data, as well. RESULTS: In the case of the computer simulation, mean counts measured from ideal data, the CVM and the Gate's method were (right: 998 +/- 209, left: 896 +/- 249), (right: 911 +/- 207, left: 815 +/- 265), and (right: 1065 +/- 267, left: 1546 +/- 267), respectively. The ideal data showed good correlation with the CVM and the correlation coefficients of the CVM, Gate's method were (right: 0.91, left: 0.93) and (right: 0.85, left: 0.90), respectively. CONCLUSION: The conjugate view method using geometric mean attenuation correction resulted in better accuracy than the Gate's method. In conclusion, the conjugate view method independent of renal depths may provide more accurate kidney uptake.

Standard Performance Measurements of GE AdvanceTM Positron Emission Tomography / 대한핵의학회잡지

PURPOSE: The purpose of this study was to establish optimal imaging acquisition conditions for the GE Advance(TM) PET imaging system by performing the acceptance tests designed by National Electrical Manufacturers Association (NEMA) protocol and General Electric Medical Systems (GEMS) test procedures. MATERIALS AND METHODS: Performance tests were carried out with 18FDG radioactivity source and phantoms by using a standard acquisition mode. Transaxial resolution and scatter fraction tests were performed with a line source and axial resolution with a point source, respectively. A cylindrical phantom made of polymethylmethacrylate (PMMA) was used to measure sensitivity, count rate losses and randoms, uniformity correction, and attenuation inserts were added to measure remaining tests. The test results were acquired in a diagnostic acquisition mode and analyzed mainly on high sensitivity mode. RESULTS: Transaxial resolution and axial resolution were measured as average of 4.65 mm and 3.98 mm at 0 cm, and 6.02 mm and 6.71 mm at 20 cm on high sensitivity mode, respectively. Average scatter fraction was 9.87%, and sensitivity was 225.8 kcps/micronCi/cc of trues. Activity at 50% deadtime was 4.6 Ci/cc, and the error of count rate correction at that activity was from 1.49% to 3.83%. Average nonuniformity for total slice was 8.37%. The accuracy of scatter correction was -0.95%. The accuracies of attenuation correction were 5.68% for air, 0.04% for water and -6.51% for polytetrafluoroethylene (PTFE). CONCLUSION: The results satisfied most acceptance criteria, indicating that the GE AdvanceTM PET system can be optimally used for clinical applications.

Effects of Scatter Correction on the Assessment of Myocardial Perfusion and Left Ventricular Function by gated Tc-99m Myocardial SPECT / 대한핵의학회잡지

PURPOSE: The purpose of this study was to evaluate the effect of scatter correction on the assessment of myocardial perfusion and left ventricular function by gated Tc-99m myocardial SPECT. MATERIALS AND METHODS: Subjects were 11 normal volunteers, 20 patients with non-cardiac chest pain and 13 patients with coronary artery diseases. We classified above 3 groups into normal and diseased groups. Scatter correction was done using dual-energy-window scatter correction method (DEW-SC). We compared acquired counts, image contrast, corrected maximum relative counts, indices of left ventricular function, extent and severity of perfusion defects calculated by 'CEqual program' between scatter non-corrected and corrected images. RESULTS: Scatter corrected studies was lower in counts by 18+/-3% than uncorrected studies, but image contrast were improved in all cases. Scatter correction using DEW-SC took 3 minutes to complete, and 512 kB memory to store. There were no significant differences among indices of left ventricular function between scatter non-corrected and corrected images. Although extents of perfusion defects were not significantly different, severity was severer in scatter corrected images. CONCLUSION: Scatter correction using DEW-SC is simple to do, and improves image contrast without changing other indices of myocardial perfusion and function.

Effect of Acute and Chronic Treatment with Risperidone on the Serotonin and Dopamine Receptors in the Rat Brain / 대한핵의학회잡지

The therapeutic efficacy of antipsychotic drugs is generally attributed to their ability to block dopamine D2 receptors. Classical D2 antagonists are not effective to treat negative symptoms and produce extrapyramidal side effects. On the other hand, atypical antipsychotic agents ameliorate negative symptoms without producing extra-pyramidal side effects, and it is reported to be associated with blockade of serotonin 5-HT2 receptors. The purpose of this study was to evaluate the effect of risperidone on neuroreceptors in the rat brain by quantitative autoradiography method. In acute treatment group, risperidone was injected into peritoneal cavity of male Wistar rats with dose of 0, 0.1, 0.25, 0.5, 1,0 and 2.0mg/kg in each Group(5/group), and they were decapitated after 2 hours. In chronic treatment group, risperidone was injected with dose of 0, 0.1, and 1mg/kg(I.P.) for 21 days and decapitated after 24 hours following last treatment. The effect of risperodone on the binding of [3H]spiperone to 5-HT2 and D2 receptors were analysed in 4 discrete regions of the striatum, nucleus accumbens, and frontal cortex by quantitative autoradiography. Acute treatment with risperidone reduced cortical 5-HT2 specific [3H]spiperone binding to 32% of vehicle-treated control. Subcortical 5-HT2 specific [3H]spiperone binding was not affected at all dose groups whereas a significant reduction (57%) in D2 specific [3H]spiperone binding was observed in risperidone treated group at doses of l-2mg/kg. Chronic treatment with risperidone produced a decrease in the maximal number of cortical 5-HT2 receptors to 51% and 46% of control in 0.1mg/kg & 1mg/kg treated group respectively. In conclusion, risperidone is a cortical serotonin receptor antagonist with relatively weak antagonistic action on dopamine receptors. These effects on neuroreceptors may explain the therapeutic effect of risperidone as a atypical antipsychotic agents.

The Measurement of Sensitivity and Comparative Analysis of Simplified Quantitation Methods to Measure Dopamine Transporters Using I-123 IPT Pharmacokinetic Computer Simulations / 대한핵의학회잡지

Recently, [I-123]IPT SPECT has been used for early diagnosis of Parkinson's patients(PP) by imaging dopamine transporters. The dynamic time activity curves in basal ganglia(BG) and occipital cortex(OCC) without blood samples were obtained for 2 hours. These data were then used to measure dopamine transporters by operationally defined ratio methods of (BG-OCC)/OCC at 2 hrs, binding potential Rv=k3/k4 using graphic method or RA= (ABBG-ABOCC)/ABOCC for 2 hrs, where ABBG represents accumulated binding activity in basal ganglia(integral 0 120minBG(t)dt) and ABOCC represents accumulated binding activity in occipital cortex(integral 0 120minBG(t)dt). The purpose of this study was to examine the IPT pharmacokinetics and investigate the usefulness of simplified methods of (BG-OCC)/OCC, RA, and RA which are often assumed that these values reflect the true values of k3/k4. The rate constants K1, k2, k3 and k4 to be used for simulations were derived using [I-123]IPT SPECT and aterialized blood data with a standard three compartmental model. The sensitivities and time activity curves in BG and OCC were computed by changing K1 and k3(only BG) for every 5min over 2 hours. The values (BG-OCC)/OCC, RA, and Rv were then computed from the time activity curves and the linear regression analysis was used to measure the accuracies of these methods. The rate constants K1, k2, k3, k4 at BG and OCC were 1.26+/-5.41%, 0.044+/-19.58%, 0.031+/-24.36%, 0.008+/-22.78% and 1.36+/-4.76%, 0.170+/-6.89%, 0.007+/-23.89%, 0.007+/-45.09%, respectively. The Sensitivities for ((delta S/S)/(delta k3/k3)) and ((delta S/delta S)/(delta K1/K1)) at 30min and 120min were measured as (0.19, 0.50) and (0.61, 0.23), respectively. The correlation coefficients and slopes of ((BG-OCC)/OCC, RA, and Rv) with k3/k4 were (0.98, 1.00, 0.99) and (1.76, 0.47, 1.25), respectively. These simulation results indicate that a late [1-123]IPT SPECT image may represent the distribution of the dopamine transporters. Good correlations were shown between (BG-OCC)/OCC, RA or Rv and true k3/k4,, although the slopes between them were not unity. Pharmacokinetic computer simulations may be very useful technique in studying dopamine transpoter systems.