Tc-99m 표지 항과립구항체 면역신티그라피를 이용한 골수염의 진단

강원준,정준기,여정석,홍미경,정재민,이동수,이상훈,최인호,이명철 ( Won Jun Kang,June Key Chung,Jeong Seok Yeo,Mee Kyoung Hong,Jae Min Jeong,Dong Soo Lee,Sang Hoon Lee,In Ho Choi,Myung Chul Lee ) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.4

Purpose: The purpose of this study was to evaluate the diagnostic accuracy of Tc-99m labeled antigranulocyte antibody immunoscintigrapy in the diagnosis of osteomyelitis and compare with the results of triphasic bone scan. Materials and Methods: The study popula- tion was 39 patients (22 male, 17 female) who had uncertain diagnoses of osteomyelitis. Fifteen patients had history of orthopedic surgery, and 5 had previous fracture. One milligram of monoclonal antibody against NCA-95 was labeled with 370 MBq of Tc-99m, injected intravenously, and 4 hour images were obtained. Triphasic bone scan images were obtained in 30 p;tients. The final diagnosis was confirmed by bacteriologic culture, biopsy or long term clinical follow up. Results: Twenty one patients were confirmed to have osteomyelitis (1 acute, 20 chronic). Eighteen patients were without osteomyelitis. Antigranulocyte antibody immunoscintigraphy had a sensitivity of 71% (15/21), and a specificity of 89% (16/18), while the sensitivity and specificity of triphasic bone scan was 93% (13/14) and 38% (6/16), respectively. Antigranulocyte antibody scan showed higher specificity of 100% (11/11) in comparison with 33% (3/9) of triphasic bone scan in patients with history of orthopedic surgery or fracture. Conclusion: Antigranulocyte antibody immunoscintigraphy is more specific than that of triphasic bone scan and may be helpful in patients with history of surgery or fracture. However, sensitivity is lower than triphasic bone scan in the detection of chronic osteomyelitis. (Korean J Nucl Med 1998;32:344-53)

악성종양에서 골수면역신티그라피를 이용한 골수전이의 평가 : $^{99m}Tc$-MDP 뼈스캔과의 비교

이경한,최창운,방영주,정준기,정홍근,이명철,김병국,김노경,고창순,Lee, Kyung-Han,Choi, Chang-Woon,Bang, Yung-Jue,Chung, Jun-Key,Chung, Hong-Keun,Lee, Myoung-Chul,Kim, Byoung-Kook,Kim, Noe-Kyeong,Koh, Chang-Soon 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.1

Although bone scan is a highly sensitive test for detecting bone metastasis, its findings are often limited in specificity and cannot be used for assessing the bone marrow. Bone marrow scintigraphy may provide useful information but previous experience with radiolabelled colloid has been disappointing. Recently, $^{99m}Tc$ labeled anti-granulocyte monoclonal antibody (anti-NCA-95 MAb) has been introduced as a new bone marrow imaging agent. To evaluate the usefulness of $^{99m}Tc$ anti-NCA MAb bone marrow scans for detecting skeletal metastasis, bone marrow scans of 44 malignant tumor patients were evaluated and compared with bone scan findings. Bone scan showed abnormal lesions in 26(59%) cases, and 18 of these patients also had an abnormal bone marrow scan. Seven of the 8 patients who had normal bone marrow scan despite bone scan lesions were confirmed to be free from metastasis. There was one case with a marrow defect despite normal bone scan but the presence of metastasis was not determined due to loss of follow up. Bone scan demonstrated a total of 64 lesions while bone marrow scan showed 38 lesions. Fifty percent (32/64) of the bone scan lesions had matching marrow defects while the remaining 50% did not. Most of these non matched lesions were suggested to be nonspecific lesions such as rib fractures or degenerative change. Meanwhile bone marrow scan was able to detect 6 new lesions not detected by bone scan, bit metastasis in each lesion was not confirmed. Bone marrow scan was also helpful in assessing equivocal bone scan lesions to be of metastatic nature in 10 patients by demonstrating a matched marrow defect. Thus $^{99m}Tc$ anti-NCA MAb bone marrow scan can help exclude metastasis in patients with nonspecific bone scan lesions and may be able to detect metastatic lesions not seen with bone scan. It appears useful as a complementary study to bone scan in evaluating malignant tumor patients.

특발성 폐섬유증에서 발견된 폐결절의 악성여부 감별에서 F-18 FDG PET의 유용성

김범산 ( Bom Sahn Kim ),강원준 ( Won Jun Kang ),이동수 ( Dong Soo Lee ),정준기 ( June Key Chung ),이명철 ( Myung Chul Lee ) 대한핵의학회 2006 핵의학 분자영상 Vol.40 No.3

목적: 특발성 폐섬유증(Idiopathic pulmonary fibrosis: IPF)에서 폐암의 발생빈도가 정상인에 비하여 증가되어 있음이 알려져 있다. IPF 환자의 흉부전산화단층촬영(chest CT)에서 폐 결절이 관찰되는 경우 폐암의 발생과 자체 IPF자체의 결절을 감별하기 어렵다. 이 연구에서는 IPF 환자의 chest CT에서 관찰된 결절의 악성 여부를 FDG PET을 이용해 분석하였다. 대상 및 방법: IPF로 진단된 환자 중, chest CT에서 악성 결절이 의심되어 FDG PET을 시행한 16명을 대상으로 하였다. 총 16명 (남: 14, 여: 2, 나이: 67.53±9.83세)의 환자에서 관찰된 28개의 결절에 대하여 FDG PET과 CT소견을 분석하였다. 대상 환자 중 2명은 소세포암과 성문하암으로 치료 받은 병력이 있었으며, 나머지 환자는 악성종양의 기왕력이 없었다. 결절의 악성도 여부는 조직검사와 CT 추적검사로 판정하였다. 결과: 10개의 결절은 폐암으로 진단되었고, 18개의 결절은 양성 결절로 판정되었다(조직병리검사: 6예, chest CT 추적검사: 22예). FDG PET의 예민도는 100%이었으며 특이도는 94.4%이었다. 크기와 형태 및 크기 변화 등을 참고한 CT의 예민도는 70%이었고, 특이도는 44.4%이었다. 악성 결절의 maxSUV는 7.68±3.96, 양성 결절은 1.22±0.65이었다(p<0.001). 폐섬유증부위에서 측정한 maxSUV는 1.80±0.43로써 악성 결절보다 낮은 값이었으며, 양성 결절보다는 높은 값이었다(p<0.001; p<0.001). CT에서 측정한 악성 결절의 크기는 23.95±10.15 mm, 양성결절은 10.83±5.23 mm이었다(p<0.02). 결론: FDG PET은 IPF 환자의 CT에서 발견된 폐 결절을 감별하는데 도움이 되었다. Purpose: Incidence of lung cancer in patients with idiopathic pulmonary fibrosis (IPF) is known to be higher than that in general population. However, it is difficult to discriminate pulmonary nodule in patients with IPF, because underlying IPF can be expressed as lung nodules. We evaluated the diagnostic performance of FDG PET in discriminating lung nodule in patients with IPF. Methods: We retrospectively reviewed 28 lung nodules in 16 subjects (age; 67.53±9.83, M:F=14:2). Two patients had previous history of malignant cancer (small cell lung cancer and subglottic cancer). The diagnostic criteria on chest CT were size, morphology and serial changes of size. FDG PET was visually interpreted, and maximal SUV was calculated for quantitative analysis. Results: From 28 nodules, 18 nodules were interpreted as benign nodules, 10 nodules as malignant nodules by histopahthology or follow-up chest CT. The sensitivity and specificity of FDG PET were 100% and 94.4%, while those of CT were 70.0% and 44.4%, respectively. Malignant nodule was higher maxSUV than that of benign lung nodules (7.68±3.96 vs. 1.22±0.65, p<0.001). Inflammatory lesion in underlying IPF was significantly lower maxSUV than that of malignant nodules (1.80±0.43, p<0.001). The size of malignant and benign nodule were 23.95±10.15 mm and 10.83 ±5.23 mm (p<0.01). Conclusion: FDG PET showed superior diagnostic performance to chest CT in differentiating lung nodules in patients with underlying IPF. FDG PET could be used to evaluate suspicious malignant lung nodule detected by chest in patients with IPF. (Nucl Med Mol Imaging 2006;40(3):163-168)

원인불명의 단백상실성 장병증

송인성(In Sung Song),김정룡(Chung Yong Kim),김용일(Yong Il Kim),정현채(Hyun Chae Jung),정준기(June Key Chung),김윤준(Yoon Jun Kim),임영석(Young Seok Lim),이대희(Dae Hee Lee),우광훈(Gwang Hoon Woo),이국래(Kook Lae Lee),한준구(Joon Koo 대한소화기학회 1997 대한소화기학회지 Vol.29 No.3

Protein-losing enteropathy is a mamfestation of various disorders associated with an excess loss of serum proteins into the gastrointestinal tract, thereby leading to hypoproteinemia and other sequelae. We present here a case of protein-losing enteropathy with unknown etiology. In spite of explorative laparotomy for multiple stricture of the small bowel, we were unable to uncover the etiology of protein-losmg entetopathy. After the resection of most severe stricture site, serum protein level was normalized, (Korean J Gsstroenterol 1997; 29: 416-421)

대장-직장암의 간전이에서 FDG PET과 MR의 진단 성능

박은경 ( Eun Kyung Park ),강원준 ( Won Jun Kang ),어재선 ( Jae Seon Eo ),이동수 ( Dong Soo Lee ),정준기 ( June Key Chung ),이명철 ( Myung Chul Lee ) 대한핵의학회 2006 핵의학 분자영상 Vol.40 No.5

게이트 심근 관류 SPECT의 관상 동맥 질환 진단 성능

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),이명묵(Myoung Mook Lee),강원준(Won Jun Kang) 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.1

N/A We studied to investigate the predictive values of gated SPECT for the improvement of wall motion after bypass surgery. As we compared postoperative SPECT with preoperative ones, we defined viability as wall motion improvement. We performed rest T1-20l/stress Tc-99m-MIBI gated SPECT in 25 patients before and 3 months after bypass surgery. Myocardial wall motion was graded as normal, hypokinesia, a kinesia, and dyskinesia by pair-wise visual analysis of gated pre and postoperative SPECT's on the same monitor wall motion abnormalities before operation, 69 (75%) improved and 23 did not. Before operation, we could find segments with good systolic thickenining 64 segments among total 92. Thickening of the remaining 28 was poor. Wall motion improved postoperatively in 45 segments (70%) among 64 with good thickening, Twenty four(86%) among 28 segments with poor thickening had also improved. We grouped segments into mild(hypokinetic) and severe(akinetic/dyskinetic) ones. Among 33 segments with severe motion abnormalities, 14 had good thickening and 19 did not. Nine(60%) improved out of 14 segments having severe abnormality with good thickening. However, 16(84%) segments out of 19 having severe abnormality with poor thickening also improved. Neither degree of perfusion decrease nor severity of wall motion abnormalities could explain the high rate of false negatives. In conclusion, as we defined viability as wall motion improvement by comparing pre and postoperative SPECT, systolic thickening observed by gated Tc-99m-MIBI SPECT in myocardial segments with wall motion abnormalities predicted wall motion improvement after bypass surgery. However, poor thickening could not be referred as evidence of nonviable myocardium both in mild and severe contractile dysfunction, so that we might need stimulation study such as dobutamine echocardiography or dobutamine gated SPECT.

수술 후 암 재발 판정에 있어서 전신 F - 18 FDG - PET의 유용성

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),강원준(Won Jun Kang),정재민(Jae Min Jeong),소영(Young So),곽철은(Cheol Eun Kwark),강순범(Soon Beum Kang),정희원(Hee Won Jung),김광현(Kwang Hyu 대한핵의학회 1997 핵의학 분자영상 Vol.31 No.3

N/A he purpose of this study was to evaluate the usefulness of whole body F-18 FDG PET scan for deceting postoperative recurrence of cancer. One hundred four cancer patients after operation were enrolled(l4 brain tumor, 15 head and neck cancer, 23 gynecologic cancer). Besides conventional images(CI) including CT and MRI, F-18 FDG PET scan was obtained on ECAT EXACT 47 scanner(Siemens-CTI), beginning 60 minutes after injection of 370MBq(10mCi) of F-18 FDG. Regional scan was also obtained with emission image. Transmission images using Ge-68 were carried out for attenuation correction in both whole body and regional images. Findings of PET and CI were confirmed by pathology or clinical follow up. The sensitivity and specificity of PET for detecting recurrence were 94% and 92%, respectively. Contrarily, the sensitivity and specific it of CI were 78% and 68% CI results were negative and PET results were positive in 11 cases. The biopsy or clinical follow-up of those cases confirmed recurrence of tumor. False negative cases of CI were frequent in patients with gynecologic cancers. Also we measured the Serum concentration of tumor markers in patients with gynecologic cancer(CA125), thyroid cancer(thyroglobulin), and colorectal cancer(CEA). The sensitivity and specificity of tumor markers were 71% and 84%, respectively. We conclude that F-18 FDG PET can be used valuably in detecting recurrent foci of a wide variety of malignancy compared to conventional diagnositic methods.

국산 항 CEA 항체의 I - 131 , Tc - 99m 표지법 확립 및 면역학적 특성 분석

고창순(Chang Soon Koh),이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),홍미경(Mee Kyoung Hong),최석례(Seok Rye Choi),서일택(Il Taek Seo),정홍근(Hong Keun Chung),정준호(Jun Ho Chung) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.2

N/A Caneer cells have several tumor-associated antigens on the cell surfaces, and antibodies against these antigens have been developed by many investigators. Radiolabeled antibodies have been used as new methods to diagnose and treat malignant tumors. Especially anti- carcinoembryonic antigen (CEA) is the most popular antibody for these purposes. In this investigation, we tried to label 131I and Tc-99m to anti-CEA monoclonal antibodies which were developed in the Seoul National University College of Medicine. We found CEA-79 and CEA-92 antibodies had the better immunological characteristics among 8 anti-CEA monoclonal antibodies. And radioiodination of CEA-79 could be performed by chloramine-T method, while radioiodination of CEA-92 by iodogen method. To label these antibodies with Tc-99m, we used pretargeting transchelation as direct labeling method. At first, Tc-99m was bound to glucaric acid, and monoclonal antibody was reduced by β-mercaptoethanol. When these were incubated together, Tc -99m bound to glucarate was switched to monoclonal antibody because of higher affinity. We established conditions of several steps in this method. Anti-CEA monoclonal antibodies labeled with 131I and Tc-99m are expected to be used valuably in the detection and treatment of malignant tumors.

양전자방출단층촬영을 이용한 국어단어와 영어단어의 어의처리 신경매개체의 특성 비교

김재진(Jae Jin Kim),김명선(Myung Sun Kim),조상수(Sang Soo Cho),권준수(Jun Soo Kwon),이재성(Jae Sung Lee),이동수(Dong Soo Lee),정준기(June Key Chung),이명철(Myung Chul Lee) 대한핵의학회 2001 핵의학 분자영상 Vol.35 No.3

N/A Purpose: This study was performed to search the relatively specific brain regions related to the semantic processing of Korean and English words on the one hand and the regions common to both on the other. Materials and Methods: Regional cerebral blood flow associated with different semantic tasks was examined using [150]H2O positron emission tomography in 13 healthy volunteers. The tasks consisted of semantic tasks for Korean words, semantic tasks for English words and control tasks using simple pictures. The regions specific and common to each language were identified by the relevant subtraction analysis using statistical parametric mapping. Results: Common to the semantic processing of both words, the activation site was observed in the fusiform gyrus, particularly the left side. In addition, activation of the left inferior temporal gyrus was found only in the semantic processing of English words. The regions specific to Korean words were observed in multiple areas, including the right primary auditory cortex; whereas the regions specific to English words were limited to the right posterior visual area. Conclusion- Internal phonological process is engaged in performing the visual semantic task for Korean words of the high proficiency, whereas visual scanning plays an important role in performing the task for English words of the low proficiency. (Korean J Nucl Med 200135:142-151)

악성종양에서 골수면역신티그라피를 이용한 골수전이의 평가 : 99mTc-MDP 뼈스캔과의 비교

고창순(Chang Soon Koh),김노경(Noe Kyeong Kim),김병국(Byoung Kook Kim),최창운(Chang Woon Choi),정준기(Jun Key Chung),방영주(Yung Jue Bang),이경한(Kyung Han Lee),정홍근(Hong Keun Chung),이명철(Myoung Chul Lee) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.1

N/A Although bone scan is a highly sensitive test for detecting bone metastasis, its findings are often limited in specificity and cannot be used for assessing the bone marrow. Bone marrow scintigraphy may provide useful information but previous experience with radiolabelled colloid has been disappointing. Recently, 99mTc labeled anti-granulocyte rnonoclonal antibody (anti-NCA-95 MAb) has been introdueed as a new bone marrow imaging agent. To evaluate the usefulness of 99mTc anti-NCA MAb bone marrow scans for detecting skeietal metastasis, bone marrow scans of 44 malignant tumor patients were evaluated and compared with bone scan fmdings. Bone scan showed abnormal lesions in 26(59%) cases, and 18 of these patients also had an abnormal bone marrow scan. Seven of the 8 patients who had normal bone marrow scan despite bone scan lesions were confirmed to be free from metastasis. There was one case with a marrow defect despite normal bone scan but the presence of metastasis was not determined due to loss of follow up. Bone scan demonstrated a total of 64 lesions while bone marrow scan showed 38 lesions. Fifty percent (32/64) of the bone scan lesions had matching marrow defects while the rernaining 50% did not. Most of these non matched lesions were suggested to be nonspecific 1esions such as rib fractures or degenerative change. Meanwhile bone marrow scan was able to detect 6 new lesions not detected by bone scan, but metastasis in each lesion was not confirmed. Bone marrow scan was also helpful in assessing equivocal bone scan lesions to be of metastatic nature in 10 patients by demonstrating a matched marrow defect. Thus 99mTc anti-NCA MAb bone marrow scan can help exclude metastasis in patients with nonspecific bone scan lesions and may be able to detect metastatic lesions not seen with bone scan. It appears useful as a complementary study to bone scan in evaluating malignant tumor patients.