소아 핵의학 검사 시 사용되는 방사성의약품의 양 산출 기준 조사

도용호,김계환,이홍재,김진의,김현주,Do, Yong-Ho,Kim, Gye-Hwan,Lee, Hong-Jae,Kim, Jin-Eui,Kim, Hyun-Joo 대한핵의학기술학회 2009 핵의학 기술 Vol.13 No.1

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. 목적 : 현재 소아 핵의학 검사 시 사용되는 방사성의약품 선량 산출 기준은 확립되어있지 않다. 그리하여 병원들은 몸무게 기준 산출 공식(mCi/kg), 체표면적 시준 산출 공식(mCi/$m^2$) 또는 미국, 유럽, IAEA의 선량 산출 공식 등 다양한 선량 기준을 따르고 있다. 그러나 이러한 선량 산출 공식들은 1세 이하의 영아나 50 kg 이상의 어린이들에 대한 정확한 선량을 산출하는데 어려움을 격고 있으므로 국내의 선량기준을 조사하여 이를 미국, 유럽, IAEA의 기준에 비교하고 각 기준의 문제점을 비교여 적절한 선량 기준의 확립을 권고 하고자 본 논문을 시행하게 되었다. 실험재료 및 방법: 객관적인 정보의 획득을 위하여 소아핵의학 검사를 가장 많이 시행하는 국내 4개 대학병원을 선정하여 설문을 실시하였으며 이에 대한 답변을 기초로 각 몸무게 당 사용되는 방사성의약품의 양을 multiplier로 변환하여 이를 미국, 유럽, IAEA의 multiplier와 비교하였다. 결과: 국민 대부분의 병원들은 몸무게 기준 산출 공식을 이용하여 소아 핵의학 검사 시 사용되는 방사성의약품의 양을 산출하고 있었으며 1세 이하의 영아와 50 kg 이상 어린이에 대한 과소량, 과잉량 투여 문제는 고려되고 있지 않은 것으로 나타났다. 결론 및 고찰: 본 논문을 통하여 대한민국의 기준을 비롯한 여러 기준들은 소아 핵의학 검사 시 적정한 선량 산출에 어려움을 겪고 있는 것으로 나타났다. 그러므로 성공적인 검사가 가능한 최소의 선량으로 방사선 피폭을 최소화 하는 세계적으로 인정된 선량 체계를 확립하여야 할 것이다. 또한 보다 우수한 영상 재구성 프로그램의 개발을 통하여 검사 시간을 단축함과 동시에 보다 나은 영상 구현을 실현하여야 할 것이다.

Optimization of block-matching and 3D filtering (BM3D) algorithm in brain SPECT imaging using fan beam collimator: Phantom study

도용호,조영권,강성현,이영진 한국원자력학회 2022 Nuclear Engineering and Technology Vol.54 No.9

The purpose of this study is to model and optimize the block-matching and 3D filtering (BM3D) algorithm and to evaluate its applicability in brain single-photon emission computed tomography (SPECT) images using a fan beam collimator. For quantitative evaluation of the noise level, the coefficient of variation (COV) and contrast-to-noise ratio (CNR) were used, and finally, a no-reference-based evaluation parameter was used for optimization of the BM3D algorithm in the brain SPECT images. As a result, optimized results were derived when the sigma values of the BM3D algorithm were 0.15, 0.2, and 0.25 in brain SPECT images acquired for 5, 10, and 15 s, respectively. In addition, when the sigma value of the optimized BM3D algorithm was applied, superior results were obtained compared with conventional filtering methods. In particular, we confirmed that the COV and CNR of the images obtained using the BM3D algorithm were improved by 2.40 and 2.33 times, respectively, compared with the original image. In conclusion, the usefulness of the optimized BM3D algorithm in brain SPECT images using a fan beam collimator has been proven, and based on the results, it is expected that its application in various nuclear medicine examinations will be possible

Liver PET/MRI 검사 시 MR 기반 호흡 움직임 보정 방법의 유용성 평가

도용호,이홍재,김진의,노경운,Do, Yong Ho,Lee, Hong Jae,Kim, Jin Eui,Noh, Gyeong Woon 대한핵의학기술학회 2018 핵의학 기술 Vol.22 No.1

PET/MRI 검사 시 호흡에 의한 움직임은 영상의 질 저하는 물론 종양의 크기, 표준섭취계수의 오차를 발생시키는 원인이 된다. 본 연구에서는 일체형 PET/MRI 장비에서 MR기반 호흡 움직임 보정 방법의 적용에 따른 종양의 표준섭취계수, 크기와 영상 품질 변화를 평가하고자 하였다. Biograph mMR 3.0T (Siemens, Germany)장비에서 2016년 3월부터 7월까지 $^{18}F-FDG$ liver PET/MRI 검사를 시행한 30명 ($62.5{\pm}10.2$세)의 데이터를 분석하였다. 7분의 PET listmode 데이터를 획득하는 동안 MR 기반 호흡 움직임 보정 방법인 MAG, MTG와 NG T1 weighted MR 영상을 획득하였다. Gated PET 영상의 재구성은 35% efficiency window가 적용된 MAG와 MTG로부터 획득된 감쇄보정영상을 이용하여 시행하였다. Non-gate, MAG, MTG 영상에서 측정된 종양의 표준섭취계수와 Z축 방향의 크기 그리고 반치폭을 분석하였다 평균 $SUV_{max}$와 $SUV_{peak}$는 NG 대비 MAG 13.15%(P<0.0001), 8.66%(P<0.0001), MTG 13.27%(P<0.0001), 8.80%(P<0.0001) 증가하였으며 Z-축에서 평균 종양의 크기와 반치폭은 MAG 14.47%(P<0.0001), 15.49%(P=0.0004), MTG 14.89%(P<0.0001), 15.79%(P=0.0003) 감소하였으며 통계적으로 유의한 차이를 보였다. MAG와 MTG 비교 평가에서 MTG의 $SUV_{max}$와 $SUV_{peak}$는 MAG 대비 0.07%(P=0.8802), 0.13%(P=0.7766) 증가하였으며 Z-축에서 평균 종양의 크기와 반치폭은 0.49%(P=0.2786), 0.36%(P=0.2488) 감소하였다. 약 7분과 2분의 추가 검사시간이 필요한 MAG와 MTG에서 표준섭취계수와 종양의 크기, 반치폭에서 통계적으로 유의한 차이가 없었다. 간 PET/MRI 검사 시 MR 기반 호흡 움직임 보정 방법을 적용하였을 때 NG 대비 MAG, MTG 모두에서 표준섭취계수와 종양의 크기 및 공간분해능이 개선되었으며 MAG와 MTG의 결과 값은 통계적으로 유의한 차이가 없었다. 호흡에 의한 움직임에 영향을 받는 다양한 상 복부 검사에 MBRMCT를 적용 시 추가적인 장비의 설치 없이 약 2분의 추가 검사시간이 필요한 MTG 방법 적용하여 NG 대비 보다 정확한 정보를 제공할 수 있을 것으로 사료된다. Purpose Respiratory motion during PET/MRI acquisition may result in image blurring and error in measurement for volume and quantification of lesion. The aim of this study was to evaluate changes of quantitative accuracy, tumor size and image quality by applying MR based respiratory motion correction technique (MBRMCT) using integrated PET/MR scanner. Materials and Methods Data of 30 patients (aged $62.5{\pm}10.2y$) underwent $^{18}F-FDG$ liver PET/MR (Biograph mMR 3.0T, Siemens) study were collected. PET listmode data for 7 minutes was simultaneously acquired with maximum average gate (MAG), minimum time gate (MTG) and non gate (NG) T1 weighted MR images. Gated PET reconstruction was performed using mu-maps generated from MAG and MTG by setting 35% of efficiency window. Maximum SUV ($SUV_{max}$), peak SUV ($SUV_{peak}$), tumor size and full width at half maximum (FWHM) in the z-axis direction of MAG, MTG and NG PET images were evaluated. Results Compared to NG, mean $SUV_{max}$ and $SUV_{peak}$ were increased in MAG 13.15%(p<0.0001), 8.66%(p<0.0001), MTG 13.27%(p<0.0001), 8.80%(p<0.0001) and mean tumor size and FWHM were decreased in MAG 14.47%(p<0.0001), 15.49%(p=0.0004), MTG 14.89%(p<0.0001), 15.79%(p=0.0003) respectively. Mean $SUV_{max}$ and $SUV_{peak}$ of MTG were increased by 0.07%(p=0.8802), 0.13%(p=0.7766). Mean tumor size and FWHM of MTG were decreased by 0.49%(p=0.2786), 0.36%(p=0.2488) compared to MAG. There was no statistically significant difference between MAG and MTG which increase total scan time for about 7 and 2 minutes. Conclusion SUV, accuracy of tumor size and spatial resolution were improved in both of MAG and MTG by applying MBRMCT without installing additional hardware in liver PET/MR study. More accurate information can be provided with the increase of 2 minutes scan time if applying MTG of MBRMCT to various abdominal PET/MR studies affected by respiratory motion.

농촌지역 공중화장실의 계획방향에 관한 연구

도용호 한국농촌건축학회 2005 농촌건축 : 한국농촌건축학회논문집 Vol.7 No.3

According to the results of analyzing the formation enterprise of beautiful public latrines, which Chungcheongnamdo is promoting, the conclusions of this study are as follows. The design for construction form should be suitable well for the surrounding environment according to the installation place of public latrines. Construction scales and sanitary appliances should be decided according to the location, use personnel, use frequency, and user type of latrines. It is not desirable to decide working expenses on the basis of pyeong irrespective of construction scale. In the purchase of building sites, because the building sites owned by the nation or the public bodies are difficult to apply the related laws, it is difficult to construct public latrines as eternal facilities. Because the building sites owned by individuals are very expensive, the execution of enterprises is difficult. Therefore, it is necessary to simplify the administrative procedures and increase the working expenses.

충남지역 공중화장실의 평면구성에 관한 연구

도용호 한국농촌건축학회 2007 농촌건축 : 한국농촌건축학회논문집 Vol.9 No.2

This thesis analyzed the uniqueness of a toilet plane structure, centering on a case of Beautiful Public Toilet Construction Project under a project by Chungcheongnam-do and drew a onclusion as followings. Most of public toilets, constructed under a project by Chungcheongnam-do, were located in remains, tourist resorts, parks, and the outskirts of traditional markets. They were constructed at the selected location within an easy access of most user and plane structure was also designed so that the persons, in charge of management and maintenance, and the users could use them without difficulty. But some public toilets didn't establish the handicaps' toilet or made them difficult to sue due to location or size. The plane structure style was various such as a rectangular, stream line, or circle in accordance with location or building size. A circle-styled toilet offered a good view but didn't offer a good access or an effective space for users. In addition, when a handicapped person enters a toilet, he or she has to enter or go out of it through a sliding dor. So a constructor has to make progress of a work in accordance with this point.

농촌생활형 펜션의 입지환경에 관한 연구 - 금산지역을 중심으로 -

도용호 한국농촌건축학회 2008 농촌건축 : 한국농촌건축학회논문집 Vol.10 No.1

The Geumsan is contiguous to Daejeon and population is decreasing every year. Consequently, the population influx, and securing source of revenue dimensional geographic and environmental benefits of the establishment of a pensions plan for the rural life style pensions research. The result is that Geumsan has a convenient traffic circumstance geographically and is a clean area as the high-level area of solid water system. Also, Geumsan forms the mountainous area whose sea-level elevation reaches to 2.5 times of the Chungcheongnam-do. Consequently, Geumsan has a suitable environment for locating many kinds of pensions like the riverside village style, the mountain village style and the villa style, the country style, the cafe style, experience style, theme style etc. So, Geumsan is found to be a suitable area to host 'rural life style' pensions, because it has wide area, small population and nice environmental conditions.

남간정사의 변천과정과 보존에 관한 연구

도용호 한국농촌건축학회 2011 농촌건축 : 한국농촌건축학회논문집 Vol.13 No.4

This thesis investigated construction aims, transitions, and preservation strategies through literatures, old documents, old maps, drawings, and photos and attained results as followings. ‘Namganjeongsa’ was built and located, centering on the thoughts of ‘Song Si Yeol’ who adored ‘zhūzǐxué’. ‘Song Si Yeol’ constructed ‘Namganjeongsa’ on a valley which was situated at a beautiful surrounding with a stream. No writing mentioned that he constructed ‘Namganjeongsa’, for there was a pond. It seems that the pond was constructed, going through many transitions, after its construction. Neighboing circumstances were damaged when ‘Gigukjeong was moved in, ‘Namgansa’ was constructed, and ‘Uamsajeok Park’ was formed. So, preservation of cultural assets, together with buildings and environment of location, are meaningful.

충남지역 장애인화장실의 공간구성에 관한 연구

都龍昊 한국농촌건축학회 2006 농촌건축 : 한국농촌건축학회논문집 Vol.8 No.3

According to the results of analyzing the space composition by focusing on the impediment persons latrines among the public latrines, the conclusions of this study are as follows. In order to eliminate the rejection feeling which the word feeling of impediment persons' latrine communicates, its name should be changed into the impediment persons latrine. Thus, the impediment persons, the old and the weak, the pregnant women and the nursing mothers, who suffer the difficulty to use the general latrines, should use such impediment persons latrines jointly. By lowering the height from the ground to the latrine floor, the impediment persons, who use their wheel chairs, should gain the easy access to such impediment persons latrines. By equipping the doorway of public latrines and impediment persons latrines with the automatic door instead of the sliding door, the impediment persons should use such latrines conveniently. The locations and sizes of impediment persons latrines differ with one another. Therefore, it is necessary to unite constantly their location, scale, and facilities.

PET/CT 검사 시 CT 피폭선량 감소 방법들의 최적화 평가

도용호,이홍재,김진의,Do, Yong Ho,Lee, Hong Jae,Kim, Jin Eui 대한핵의학기술학회 2015 핵의학 기술 Vol.19 No.2

PET/CT 검사 시 피폭 선량 감소를 위한 방법들이 지속적으로 개발되고 있다. 본 논문에서는 사용자에 의해 parameter 변경이 가능한 3가지 방법인 automatic exposure control(AEC), automated dose-optimized selection of X-ray tube voltage(CAREkV), sinogram affirmed iterative reconstruction(SAFIRE) 적용 시 각 방법의 적용 시와 3가지 방법의 조합에 따른 피폭선량 감소효과와 영상의 질 그리고 SUV 변화 유무를 평가하였다. Bograph mCT64 (Siemens, Germany)장비를 사용하여 anthropomorphic head, chest, pelvis phantom을 torso 모형으로 접합하여 스캔하였다. 120 kV, 40 mAs 조건으로 AEC의 적용 유무와 120 kV, 40 mAs AEC 조건으로 CAREkV의 적용 유무에 따른 피폭 선량 감소 효과를 평가 하였다. 120 kV, 25 mAs SAFIRE 조건에서 영상을 획득하여 120 kV, 40 mAs SAFIRE 미적용 시 대비 노이즈와 피폭선량 감소효과가 평가되었다. 120 kV, 40 mAs AEC 적용, 120 kV, 25 mAs 3가지 방법의 조합 조건으로 AAPM perfomance, anthropomorphic, IEC body phantom을 스캔하여 노이즈, 공간 분해능, 피폭선량 감소효과 그리고 PET SUV의 변화 유무를 평가하였다. AEC 적용 시, 미적용 대비 CTDIvol 50.52%, DLP 50.62% 감소하였다. CAREkV 적용 시 100 kV가 적용됨에 따라 mAs가 61.5% 증가하였으나 CTDI 6.2%, DLP 5.5% 감소하였다. Reference mAs를 낮게 지정할수록, strength값을 높게 지정할수록 피폭선량 감소 효과는 증가하였다. SAFIRE의 경우 40 mAs에서 25 mAs로 tube current를 37.5% 감소시켰음에도 불구하고 mean SD 2.2%, DLP 38% 감소하였다. AAPM phantom에서는 3가지 방법의 조합 시 AEC 대비 SD는 5.17% 감소하였으며 공간 분해능의 경우 유의한 차이가 없었다. Torso phantom의 경우 3가지 조합에서 AEC 대비 mean SD 6.7% 증가, DLP 36.9% 감소하였으며 IEC phantom 실험에서 PET SUV는 통계적으로 유의한 차이가 없었다(P>0.05). 본 논문에서 CT선량 감소를 위한 각 방법들 모두 피폭 선량 감소 효과를 보였으며 3가지 방법의 조합을 통하여 화질 저하와 PET SUV 변화 없이 AEC만 적용 시 대비 36.9%의 선량감소 효과가 있는 것으로 나타났다. 선량 감소 방법들의 최적화를 통하여 환자 피폭선량 저감화를 위한 지속적인 노력이 필요하며 특히 방사선 감수성이 높은 소아 환자에 적극적으로 적용되어야 할 것으로 사료된다. Purpose Various methods for reducing radiation exposure have been continuously being developed. The aim of this study is to evaluate effectiveness of dose reduction, image quality and PET SUV changes by applying combination of automatic exposure dose(AEC), automated dose-optimized selection of X-ray tube voltage(CAREkV) and sinogram affirmed iterative reconstruction(SAFIRE) which can be controled by user. Materials and Methods Torso, AAPM CT performance and IEC body phantom images were acquired using biograph mCT64, (Siemens, Germany) PET/CT scanner. Standard CT condition was 120 kV, 40 mAs. Radiation exposure and noise were evaluated by applying AEC, CAREkV(120 kV, 40 mAs) and SAFIRE(120 kV, 25 mAs) with torso phantom compare to standard CT condition. And torso, AAPM and IEC phantom images were acquired with combination of 3 methods in condition of 120 kV, 25 mAs to evaluate radiation exposure, noise, spatial resolution and SUV changes. Results When applying AEC, CTDIvol and DLP were decreased by 50.52% and 50.62% compare to images which is not applying AEC. mAs was increased by 61.5% to compensate image quality according to decreasing 20 kV when applying CAREkV. However, CTDIvol and DLP were decreased by 6.2% and 5.5%. When reference mAs was the lower and strength was the higher, reduction of radiation exposure rate was the bigger. Mean SD and DLP were decreased by 2.2% and 38% when applying SAFIRE even though mAs was decreased by 37.5%(from 40 mAs to 25 mAs). Combination of 3 methods test, SD decreased by 5.17% and there was no significant differences in spatial resolution. And mean SD and DLP were decreased by 6.7% and 36.9% compare to 120 kV, 40 mAs with AEC. For SUV test, there was no statistical differences(P>0.05). Conclusion Combination of 3 methods shows dose reduction effect without degrading image quality and SUV changes. To reduce radiation exposure in PET/CT study, continuous effort is needed by optimizing various dose reduction methods.

¹⁸F-FDG Brain PET/CT 검사를 위한 데이터 비교 방법의 평가

도용호,이홍재,김진의,Do, Yong Ho,Lee, Hong Jae,Kim, Jin Eui 대한핵의학기술학회 2015 핵의학 기술 Vol.19 No.1

Brain PET/CT 검사는 뇌의 정신활동 뿐만 아니라 혈액의 관류상태, 에너지원의 대사상태, 생리적 활성물질의 섭취 정도를 관찰할 수 있으며 이를 통계적으로 분석하기 위한 다양한 데이터 비교 방법들이 적용되고 있다. 본 논문에서는 다양한 데이터 비교 방법들 중 SPM과 scenium의 유용성을 비교 평가 하였다. 2014년 3월부터 7월까지 서울대학교병원에서 18F-FDG PET/CT 검사를 시행 받은 15명(평균연령 $62.02{\pm}15.03$세, abnormal 10명, normal 5명)의 데이터를 분석하였다. 사용된 장비는 Siemens사의 Biograph Truepoint40 with TrueV이며 데이터 분석을 위하여 SPM99, syngo.via version VA30A, scenium version 4.0이 사용되었다. 검사는 $^{18}F-FDG$를 kg당 3.7MBq 주사하여 30분 후 brain emission 영상을 10분 획득하였다. 획득된 영상을 이용하여 영상 판독과 SPM, scenium 결과의 일치성을 5명의 핵의학과 판독의가 평가하였다. Scenium에서 parameter 변경에 따른 SUV와 SD 변화를 평가하기 위하여 환자 data 재구성시 iteration 4, 6, 8, gaussian filter 2mm, 4mm, 8mm, matrix size 168, 256, 336의 변화를 주어 재구성후 증감을 평가하였다. 마지막으로 3명의 방사선사가 두 software를 이용하여 평균 결과 분석 시간을 평가하였다. 영상 판독과 SPM 결과의 일치성은 normal 89.5%, abnormal 73.2%로 normal 환자에서 보다 높은 일치성을 보였으며 total 84.1%의 일치하는 것으로 나타났다. Scenium에서는 normal 92.1%, abnormal 93.0% 그리고 total 92.4%로 나타났다. Scenium에서 parameter 변경에 따른 SUV와 SD 변화 평가에서 iteration 횟수와 matrix size가 감소할수록 SUV와 SD 값은 iteration 변화에서 최대 0.59%, 8.73% 그리고 matrix size 변화에서 최대 0.88%, 8.25% 감소하였다. Gaussian filter변화에서는 FWHM이 증가할수록 SUV와 SD값은 최대 4.69%, 20.38% 감소하였다. 두 software를 이용한 평균 결과 분석 시간은 SPM 282초, scenium 116초로 scenium으로 결과 분석 시 SPM 사용 시 보다 58.% 시간이 감소되었다. 데이터 비교 평가 software들의 장단점을 충분히 이해하고 각 병원의 장비 환경과 실정에 맞는 software를 적용한다면 brain PET/CT 검사 시 보다 많은 정보를 제공할 수 있을 것으로 사료된다. Purpose Various database comparison methods(DCM) are used for analyzing functional neuro-imaging. It is possible to statistically evaluate decreased or increased metabolism of abnormal patient's brain by comparing with asymptomatic controls in DCM. And results of DCM are additionally used for easily explaining defect region. The aim of this study was to evaluate usefulness of statistical parametric mapping(SPM) and scenium. Materials and Methods Data of 15 patients($62.02{\pm}15.03year$) underwent $^{18}F-FDG$ brain PET/CT were collected and analyzed. Biograph TruePoint 40 with TrueV, (Siemens) was used as a PET/CT scanner. Scenium(version 4.0) in Syngo.via(version VA30A) and SPM99 were applied for statistical evaluation. Consistency between PET reading and result of DCM were evaluated by 5 nuclear medicine physicians through a questionnaire survey. SUV and SD changes were evaluated by changing iteration, gaussian filter and matrix size in scenium. And average required time for generating result of SPM99 and scenium was compared by 3 medical technologists. Results Consistency from the result of SPM99 and scenium showed 84% and 92.4% compare to PET reading. When iteration 4, FWHM 8 and matrix size 168, SUV and SD were decreased by 0.59%, 8.73%, 4.69%, 20.38% and 0.88%, 8.25% respectively compare to routine parameter(iteration 8, FWHM 2 and matrix size 336) of scenium. Average required time of SPM99 and Scenium took 282 seconds and 116 seconds to generate result. Conclusion Results of SPM99 and Scenium showed high consistency compare to PET reading. Various parameters can be controled by user when using SPM. However, normal database needs to be acquired. And it takes significant amount of time and effort for the first set up. On the other hand, Scenium provides normal database even though modifiable parameters are limited. Therefore, more informations could be provided for brain PET/CT if properly understanding and selecting each DCM.