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김병태(Byung Tae Kim),김상은(Sang Eun Kim),김준영(Joon Young Kim),최용(Yong Choi),이경한(Kyung Han Lee),최연성(Yearn Seong Choe),김종호(Jong Ho Kim),임기천(Ki Chun Im) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.6
The goals of developments in nuclear medicine instrumentation are to offer a higher-quality image and to aid diagnosis, prognosis assessment or treatment planning and monitoring. It is necessary for physicists and engineers to improve or design new instrumentation and technique, and to implement, validate, and apply these new approaches in the practice of nuclear medicine. The researches in physical properties of detectors and crystal materials and advance in image analysis technology have improved quantitative and diagnostic accuracy of nuclear medicine images. This review article presents recent developments in nuclear medicine instrumentation, including scatter and attenuation correction, new detector technology, tomographic image reconstruction methods, 511 keV imaging, dual modality imaging device, small gamma camera, PET developments, image display and analysis methods.
CT상 악성여부가 불명확한 단일 폐결절에서의 양전자방출단층촬열술의 유용성
김병태(Byung Tae Kim),김상은(Sang Eun Kim),최용(Yong Choi),이경한(Kyung Han Lee),최연성(Yearn Seong Choe),윤석부(Seok Boo Yoon),최준영(Joon Young Choi),김선정(Sun Jung Kim),권오정(O Jung Kwon),이경수(Kyung Soo Lee) 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.1
N/A About one-third of radiologically indeterminate solitary pulmonary nodules (SPN) are eventually turned out to be malignant. It is very important to noninvasively determine whether the SPN is malignant or not for the decision of its way of management. PET imaging is highlighted by its unique ability of imaging the function and metabolism of cells. Glucose metabolism is increased in malignant transformed cells. We performed FDG-PET studies in patients who ha radiologi- cally indeterminate SPN and compared the findings with histologic diagnoses to assess the diagnostic accuracy in the detection of malignancy and to decide which parameter is the most suitable for clinical practice among peak SUV (pSUV), average SUV (aSUV), 50/10 ratio, and time-activity curve (TAC). Thirty patients were included in this study and the most useful parameter was pSUV. The sensitivity and specificity in the detection of malignant SPN using 3.5 as a cut off pSUV were both 87%. Interestingly, all 2 false-negative cases were bronch- ioloalveolar carcinoma on histologic examination. If these cases, which could be strongly suspected by CT findings, were excluded, the sensitivity of pSUV was 100%. In conclusion, PET imaging is very helpful for determining malignancy in indeterminate SPN and pSUV is a conveniently measurable parameter which is valuable for interpretation.
철운단백질 포화정도에 따른 Gallium-67 체내분포의 변화
김병태(Byung Tae Kim),김상은(Sang Eun Kim),이경한(Kyung Han Lee),최준영(Joon Young Choi) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.1
We present a case of a young female patient with fulminant hepatitis who showed an altered biodistribution of Ga-67, after being scanned twice at 10 month intevals. On initial scan, uptake of Ga-67 was increased in the liver, kidneys, and skeletons. Increased hepatic Ga-67 uptake may be explained by increased transferrin unbound Ga-67 that was taken up by the inflamed liver. The saturation of iron-binding proteins due to multiple transfusions may lead to increased renal and skeletal Ga-67 uptake. On follow-up scan hepatic Ga-67 uptake was markedly increased. Also increased Ga-67 uptake in the axial skeleton and normalized renal uptake were shown. The findings were consistent with iron deficiency anemia. This case demonstrates altered Ga-67 biodistribution associated with multiple transfusions, fulminant hepatitis, and iron deficiency anemia.
N - 13 암모니아와 양전자방출단층촬영 동적영상을 이용하여 심근혈류량을 정량화하는 새로운 방법 개발에 관한 연구
김병태(Byung Tae Kim),김상은(Sang Eun Kim),김준영(Joon Young Kim),최용(Yong Choi),이경한(Kyung Han Lee),최연성(Yearn Seong Choe),주희경(Hee Kyung Ju),김영진(Yong Jin Kim) 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.1
N/A Regional myocardial blood flow (rMBF) can be noninvasively quantified using N-13 ammonia and dynamic positron emission tomography (PET). The quantitative accuracy of the rMBF values, however, is affected by the distortion of myocardial PET images caused by finite PET image resolution and cardiac motion. Although different methods have been developed to correct the distortion typically classified as partial volume effect and spillover, the methods are too complex to employ in a routine clinical environment. We have developed a refined method incorporating a geometric model of the volume representation of a region-of-interest (ROI) into the two- compartment N-13 ammonia model. In the refined model, partial volume effect and spillover are conveniently corrected by an additional parameter in the mathematical model. To examine the accuracy of this approach, studies were performed in 9 coronary artery disease patients. Dynamic transaxial images (16 frames) were acquired with a GE AdvanceTM PET scanner simultaneous with intravenous injection of 20 mCi N-13 ammonia. rMBF was examined at rest and during pharmacologically (dipyridamole) induced coronary hyperemia. Three sectorial myocardium (septum, anterior wall and lateral wall) and blood pool time-activity curves were generated using dynamic images from manually drawn ROIs. The accuracy of rMBF values estimated by the refined method was examined by comparing to the values estimated using the conventional two-compartment model without partial volume effect correction. rMBF values obtained by the refined method linearly correlated with rMBF values obtained by the conventional method (108 myocardial segments, correlation coefficient (r)=0.88). Additionally, underestimated rMBF values by the conventional method due to partial volume effect were corrected by theoretically predicted amount in the refined method (slope(m)=1.57). Spillover fraction estimated by the two methods agreed well (r=1.00, m=0.98). In conclusion, accurate rMBF values can be efficiently quantified by t
좌심실기능이상을 동반한 심근경색 병력이 있는 환자에서 Tl-201 재분포 SPECT와 휴식기 N-13 Ammonia PET: 분절 비교 및 불일치 분석
최준영 ( Joon Young Choi ),이경한 ( Kyung Han Lee ),김영환 ( Young Hwan Kim ),이은정 ( Eun Jeong Lee ),정현우 ( Hyun Woo Chung ),이수진 ( Su Jin Lee ),이상훈 ( Sang Hoon Lee ),김병태 ( Byung Tae Kim ) 대한핵의학회 2004 핵의학 분자영상 Vol.38 No.3
목적: 이 연구에서는 좌심실기능이상을 동반한 심근경색 병력이 있는 환자에서 생존 가능한 심근을 평가하기 위하여 시행한 휴식기 N-13 ammonia PET과 Tl-201 재분포 SPECT를 분절단위로 비교해 보고, PET/SPECT 불일치를 일으키는 기전을 알아보았다. 대상 및 방법: 심근경색 병력과 좌심실기능이상, 그리고 약물부하-휴식 Tl-201 SPECT 상 1분절 이상의 고정관류결손이 있는 18명(남 17, 여 1; 나이 59.7±8.9세)을 대 We compared rest perfusion PET with redistribution perfusion SPECT to investigate the concordant rate between PET and SPECT images and analyze the discordant pattern. Materials and Methods: Rest N-13 ammonia and F-18 FDG PET were performed on 18 patients
처음 진단된 두경부 선양낭성암종에서 18F-FDG PET/CT: 임상상 및 병리소견과의 상관성
이지영 ( Ji Young Lee ),최준영 ( Joon Young Choi ),고영혜 ( Young Hyeh Ko ),백정환 ( Chung Hwan Baek ),손영익 ( Young Ik Son ),조숙경 ( Suk Kyong Cho ),천미주 ( Mi Ju Cheon ),이경한 ( Kyung Han Lee ),김병태 ( Byung Tae Kim ) 대한핵의학회 2009 핵의학 분자영상 Vol.43 No.5
목적: 처음 진단된 두경부 선양낭성암종의 18F-FDG PET/CT의 영상소견을 선양낭성암종의 병리적 소견, 병기 결정, 가장 흔한 두경부암인 편평세포암종의 18F-FDG 섭취양상, 예후와 상관 지어 알아보았다. 대상 및 방법: 두경부 선양낭성암종으로 처음 진단되어 18F-FDG PET/CT를 시행한 16명의 환자가 대상이었다. PET/CT의 병기 결정 능력을 알아보고, 두경부 선양낭성암종의 SUVmax를 원발종양의 조직학적 아형(고형 대 관상형/사상형상), 병변의 크기와 일치하는 두경부 편평세포암종의 SUVmax, 무병생존율과 비교하였다. 결과: 16명의 환자들 중, 관상형 또는 사상형을 가진 군은 10명이었고 나머지 6명은 고형을 가진 군이었다. 고형 선양낭성암종의 SUVmax는 관상형 또는 사상형 선양낭성암종 보다 유의하게 높았다(6.7±3.2 vs. 4.2±0.9, p=0.03). 18F-FDG PET/CT로 기존 영상법에서 발견하지 못한 원격 전이를 18.7%의 환자에서 발견하여, 치료방침 변경에 기여하였다. 선양낭성암종의 SUVmax는 병변 크기가 같은 편평세포암종과 비교해 보았을 때 유의하게 낮았다(5.1±2.4 vs. 13.6±6.0, p<0.001). 조직학적 아형에 따른 무병생존율은 통계적으로 유의한 차이를 보이지 않았다. 반면에, 원발종양의 SUVmax가 6.0 이상인 환자들의 무병생존율은 SUVmax가 6.0 미만인 환자들보다 유의하게 낮았다(p=0.002). 결론: 두경부 선양낭성암종의 18F-FDG 섭취양상은 조직학적 아형과 무병생존율과 유의한 관계가 있다. 18F-FDG PET/CT는 기존 영상법에서 발견하지 못한 원격전이 진단에 유용한 것으로 보인다. 사상형상 또는 관상형 선양낭성암종의 18F-FDG 섭취는 낮을 수 있어, 선양낭성암종이 의심되지 않은 환자들의 PET 영상 판독에 주의가 필요하다. Purpose: We evaluated 18F-FDG PET/CT findings in initially diagnosed adenoid cystic carcinoma (ACC) of the head and neck in association with pathological subtype, staging, uptake comparison with squamous cell carcinoma (SqCC) and prognosis. Materials and Methods: The subjects were 16 patients with initially diagnosed ACC of head and neck who underwent pretreatment 18F-FDG PET/CT. Histological subtype (solid pattern vs. tubular/cribriform pattern), SUVmax of size-matched SqCC of the head and neck as control group, disease-free survival (DFS) were compared with the SUVmax of ACC of the head and neck. Results: Of total 16 patients, 6 had solid pattern and the remaining 10 had tubular/cribriform pattern. The SUVmax were significantly higher in solid pattern group than in tubular/cribriform pattern group (6.7±3.2 vs. 4.2±0.9, p=0.03). PET/CT found unexpected distant metastasis in 18.7% of patients (3/16) and changed the therapeutic plan in those patients. The SUVmax of ACC was significantly lower than that of size-matched SqCC (5.1±2.4 vs. 13.6±6.0, p<0.001). DFS was not significantly different according to the histological subtype. In contrast, patients with high 18F-FDG uptake (SUVmax≥6.0) had significantly shorter DFS than those with low 18F-FDG uptake (SUVmax<6.0). Conclusion: 18F-FDG uptake of ACC of the head and neck is significantly associated with histological subtype and DFS. 18F-FDG PET/CT may be useful for detecting unexpected metastasis. Since 18F-FDG uptake of tubular/cribriform ACC compared with SqCC is relatively low, it is necessary to interpret PET images carefully in patients without alleged ACC. (Nucl Med Mol Imaging 2009;43(5):395-401)
폐 종양 FOG PET 영상의 다양한 추적자 역학 분석 방법 개발과 유용성 고찰
김준영,최용,최준영,이경한,김상은,최연성,김영진,김병태 ( Joon Young Kim,Yong Choi,Joon Young Choi,Sang Eun Kim,Yearn Seong Choe,Kyung Han Lee,Yong Jin Kim,Byung Tae Kim ) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.4
Purpose: The purpose of this study was to assess the diagnostic accuracy of various quantitation methods using F-18-fluorodeoxyglucose (FDG) in patients with malignant or benign lung lesion. Materials and Methods: 22 patients (13 malignant including 5 bronchoalverolar cell cancer; 9 benign lesions including 1 hamartoma and 8 active inflammation) were studied after overnight fasting. We performed dynamic PET imaging for 56 min after injection of 370 MBq (10 mCi) of FDG. Standardized uptake values normalized to patients body weight and plasma glucose concentration (SUVglu) were calculated. The uptake rate constant of FDG and glucose metabolic rate were quantified using Patlak graphical analysis (Kpat and Mrpat), three compartment-five parameter model (K5p, MR5p), and six parameter model taking into account heterogeneity of tumor tissue (K6p, MR6p), Areas under receiver operating charac-teristic curves (ROC) were calculated for each method. Results: There was no significant difference of rate constant or glucose metabolic rate measured by various quantitation methods between malignant and benign lesions. The area under ROC curve were 0.73 for SUVglu, 0.66 for Kpat, 0.77 for Mrpat, 0.71 for KSp, 0.73 for MRSp, 0.70 for K6p, and 0.78 for MR6p, No significant difference of area under the ROC curve between these rne- thods v;as observed except the area between Kpat vs. Mrpat (p<0.05). Conclusion: Quan- titative methods did not improve diagnostic accuracy in comparison with nonkinetic methods. However, the clinical utility of these methods needs to be evaluated further in patients with low pretest likelihood of active inflammation or bronchoalveolar cell carcinoma. (Korean J Nucl Med 1998;32:332-43)
FDG - PET을 이용한 악성과 양성 연부조직 병변의 감별 : 반정량적 지표간의 비교
김병태(Byung Tae Kim),김상은(Sang Eun Kim),이경한(Kyung Han Lee),최준영(Joon Young Choi),최용(Yearn Seong Choe),최연성(Yong Choi),서재곤(Jai Gon Seo) 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.1
N/A The purpose of this study is to evaluate the diagnostic accuracy of various quantitative indices for the differentiation of benign from malignant primary soft tissue tumors by FDG-PET. A series of 32 patients with a variety of histologically or clinically confirmed benign (20) or malignant (12) soft tissue lesions were evaluated with emission whole body (5min/bed position) PET after injection of [18F]FDG. Regional 20min transmission scan for the attenuation correction and calculation of SUV was performed in 16 patients (10 benign, 6malignant) followed by dynamic acquisition for 56min. Postinjection transmission scan for the attenuation correction and calculation of SUV was executed in the other 16 patients (10 benign, 6 malignant). The following indices were obtained : the peak and average SUV (pSUV, aSUV) of lesions, tumor-to-background ratio acquired at images of 51 min p.i. (TBR51), tumor-to-background ratio of areas under time-activity curves (TBRarea) and the ratio between the activities of tumor ROI at 51 min p.i. and at the time which background ROI reaches maximum activity on the time-activity curves (T51/Tmax). The pSUV, aSUV, TBR51, and TBRarea, in malignant lesions were significantly higher than those in benign lesions. We set the cut-off values of pSUV, aSUV, TBR51, TBRarea and T51/Tmax for the differentiation of benign and malignant lesions at 3.5, 2.8, 5.1, 4.3 and 1.55, respectively. The sensitivity, specificity and accuracy were 91.7%, 80.0%, 84.4% by pSUV and aSUV, 83.3%, 85.0%, 84.4% by TBR51, 83.3%, 100%, 93.8% by TBRarea and 66.7%, 70.0%, 68.8% by Tsl/Tmax. The time-activity curves did not give additional information compared to SUV or TBR. The one false negative was a case with low-grade fibrosarcoma and all four false positives were cases with inflammatory change on histology. The visual analysis of FDG-PET also detected the metastatic lesions in malignant cases with comparable accuracy. In conclusion, all pSUV, aSUV, TBR51, and TBRarea are useful metabolic semi-quantitative indices with good accuracy for the differentiation of benign from malignant soft-tissue lesions.