위암조직에서 종양관련항원 TAG - 72와 CEA의 농도 및 분포

정준기,이명철,정홍근,고창순,임상무,장자준 ( June Key Chung,Myung Chul Lee,Hong Keun Chung,Chang Soon Koh,Sang Moo Lim,Ja Joon Jang ) 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.2

진단적 방사성옥소 전신스캔이 음성인 갑상선 재발암의 진료

정준기(June Key Chung) 대한핵의학회 2001 핵의학 분자영상 Vol.35 No.3

Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine trapping mechanism. In such cases, various nuclear imaging methods including TI-201, Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose 1-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose 1-131 therapy, with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose 1-131 therapy. Before 1-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance 1-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose 1-131 therapy. (Korean J Nucl Med 200135:117-124)

갑상선암에서 핵의학 진료 연구

정준기 ( June-key Chung ) 대한갑상선학회 2010 International Journal of Thyroidology Vol.3 No.1

After specific accumulation of iodide in the thyroid gland was found, nuclear medicine techniques including radioactive iodine have been important roles in the management of differentiated thyroid cancer. For the detection of cancer recurrence/metastasis after thyroidectomy, serum Tg measurement is the most sensitive modality. However, it is affected in the presence of anti-Tg antibody. Persistently elevated anti-Tg antibody levels appear to serve as a useful marker for residual cancer. A significant number of differentiated thyroid cancer patients had negative Tg level with negative anti-Tg antibody despite a positive radioiodine scan finding. Diffuse liver uptake on whole-body scan without thyroid remnant or metastasis suggests hidden metastases. FDG PET scan localizes metastatic sites in radioiodine scan-negative carcinoma patients with high accuracy. We found that lung metastases were completely resolved in 35%, and partially resolved in 40% after I-131 therapy. The treatment to bone metastasis needed combination therapy with surgical resection or external radiation therapy. When patients are refractory to the conventional fixed dose of I-131 therapy, the administration dose could be increased within maximal safe dose based on radiation dose to the bone marrow. The other could be using retinoic acid to induce re-differentiation and to restore the accumulation of radioiodine in cancer cells. NIS activity is the molecular basis of radioiodine therapy in thyroid cancer. Several medications have been investigated to enhance the expression of NIS gene and protein. The recent cloning and characterization of the NIS gene has paved the way for the development of novel radionuclide gene therapy. This novel therapy is being improved by several modified approaches, and can be applied in the near future.

심장핵의학의 현황과 전망

정준기 ( June Key Chung ) 대한핵의학회 2009 핵의학 분자영상 Vol.43 No.3

82Sr/82Rb 발생기의 제조 및 정상인 심근의 양전자 단층촬영상

정재민,정준기,이동수,곽철은,이경한,이명철,고창순 ( Jae Min Jeong,June Key Chung,Dong Soo Lee,Cheol Eun Kwark,Kyung Han Lee,Myung Chul Lee,Chang Soon Koh ) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.3

A Sr/Rb generator was prepared by loading Sr to preconditioned tin dioxide column. The generator was eluted by normal saline with flow rate up to 8ml/min, and the eluted radioactivity was monitored by dose calibrator. Radioactivity began to come out at 5ml and reached to peak around 9ml. The total eluted radioactivity increased linearly with flow rate, and the maximum obtained radioactivity was 35mCi at 8ml/min. The Rb preparation was proven to be free from both strontium radioactivity and pyrogen. The Rb was injected to normal female valunteer and positron emission tomographic image of heart was obtained successfully.

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)

Tc-99m-MIBI 심근 SPECT에서 재구성필터의 차단주파수에 의한 인위적 관류결손의 정량적 평가

곽철은,정준기,이명철,Kwark, Cheol-Eun,Chung, June-Key,Lee, Myung-Chul 대한의용생체공학회 1995 의공학회지 Vol.16 No.2

Tc-99m-MIBI 심근 SPECT에서 심근조직에 비하여 간섭취가 상대적으로 높고 이들이 서로 가까이에 위치해 있는 경우 단축단면상의 하위부 또는 하위중격부에서 발생하는 인위적 관류결손의 정도와 여과기의 차단주파수의 관계를 분석하였다. 이러한 영향은 단축단면상 뿐만 아니라 심근 극성지도에서도 관찰되는데, 심근단층상에서 계수분포가 균일하지 못하고 간과 같이 특정부위에 방사능의 집적도가 높은 경우 단층상 재구성시 차단 파수의 적절한 설정에 따라 이 효과를 줄일 수 있는 방법을 제안하였다. 본 연구에서 분석에 사용된 여과기는 저역통과여과기로 이를 사용하는 경우에는 차단주파수를 0.4Nyquist 이상으로 하면 인위적 관류결손의 정도를 충분히 줄일 수 있었다. 그러나 높은 차단주파수에서는 심근영상의 균일도가 떨어지고 배후방사능 및 기타 잡음요인이 효과적으로 제거되지 않기 때문에 적절한 차단주파수의 설정이 중요하며, 본 연구에 사용된 영상에서 여과방법에 따른 원주프로필의 변화가 미세하여 후처리방법을 사용하여 분석하였다. 또한 역투사방법이 비선형적이므로 특정 영상보다는 다양한 간-심근 방사능비에 따른 영상을 분석하여 비선형성을 배제한 연구가 향후 진행되어야 한다. Tc-99m-MIBI (Sestamibi) myocardial SPECT along with TI-201 tomographic Imaging has demonstrated wide application and high image quality sufficient for the diagnosis of myocardial perfusion defect, which consequently reflects regional myocardial blood flow. The qualitative values of myocardial SPECT with Tc-99m-MIBI as well ds the quantitative cases depend in some degree on the reconstruction techniques of multiple projections. Filtered backprojection (FBP) Is the common standard method for reconstruction rather than the complicated and time-consuming arithmetic methods. In FBP it is known that the distribution of radioactivity in reconstructed transverse slices varies with the selected litter parameters such as cutoff frequencies and order (Butterworth case) The cutoff frequencies used in clinicAl practice partially remove and decrease the true radioactive distribution and alter the pixel counts, which lead to underestimation of true counts in specific myocardial regions. In this study, we have investigated the effect of cutoff frequencies of reconstruction filter on the artifactually induced perfusion defects, which are often demonstrated near inferior and/or inferoseptal cardiac walls due to the intense hepatic uptake of Tc-99m-MIBI. A computerized method for Identifying the relative degree of artifactual perfusion defect and for comparing those degrees along with the relative amount of hepatic uptake to myocardium was developed and patient images were studied to observe the quantitative degree of underestimation of myocardial perfusion, and to propose some reasonable threshold of cutoff frequency in the diagnosis of perfusion defect quantitatively. We concluded that from the quantitative viewpoint cutoff frequencies may be used as high as possible with the sacrifice of homogeneity of image quality, and those frequencies lower than the common 0.3 Wyquist frequency would reveal severe degradation of radioactive distribution near inferior and/or inferoseptal myocardium when applying Butterworth or low pass filter.

정상 한국 성인에서 혈청 암태아성항원의 경계치 및 이에 영향을 미치는 인자

김선욱,정준기,이동수,곽철은,정재민,김명기,이명철,고창순,이형기,유근영,안윤옥,김종순 ( Sun Wook Kim,June Key Chung,Dong Soo Lee,Cheol Eun Kwark,Jae Min Jeong,Myung Ki Kim,Myung Chul Lee,Chang Soon Koh,Hyung Kee Lee,Keun Young Yoo,Yoon Ok 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.3

Carcinoembryonic Antigen is one of most frequent.ly checked tumor markers in cancer management. We performed statistical analysis with serum CEA data of 2626 persons who received regular health examination and were thought to be free of active disease to determine the cutoff values of serum CEA level in normal Korean adults and to study the factors influencing serum (:EA levels in normal subjects. 1) The cutoff values of serum CEA in normal Korean adults in general were 9.28ng/ ml for men, 5.90 ng/ml for women. 2) Serum CEA level was influenced by age, present smoking history, sex, and abnormal findings in chest X ray. 3) Serum CEA level had no correlation with the history of amount of alcohol consumption or obesity. 4) Cutoff values of serum CEA in normal Korean adults were tabulated according to age, sex, and smoking histor y. Serum CEA level was influenced by age, sex, present smoking history and abnormal findings in chest X ray and cutoff values of serum CEA were tabulated according to age, sex, and smoking history.

관상동맥질환에서 휴식기의 심근관류 정도와 휴식기 심기능 변화의 비교 - Dipyridamole 부하 99mTc - MIBI SPECT와 휴식기 Gated Blood Pool Scan -

이명철(Myung Chul Lee),정준기(June Key Chung),이영우(Young Woo Lee),서정돈(Jung Don Seo),박영배(Young Bae Park),이동수(Dong Soo Lee),김상은(Sang Eun Kim),최창운(Chang Woon Choi),이명묵(Myoung Mook Lee),고창순(Chang Soon Ko),배상균(Sa 대한핵의학회 1992 핵의학 분자영상 Vol.26 No.2

N/A Rest gated blood pool scan (Rest GBP scan) and dipyridamole Tc-99m-MIBI SPECT were performed in 34 patients with or suspected coronary artery disease. Both studies were performed within 2∼32 days (mean 8.1 days). A significant correlation was present between left ventricular ejection fraction (r=-0.7356, p〈0.001) and peak ejection rate and peak filling rate in rest GBP scan and perfusion defect in MIBI SPECT. And there were acceptable correlations (0.05〈p〈0.001) between regional ejection fractions and perfusion defects corresponding to the regions. There were 39 segments of fixed (rest) perfusion defects in MIBI SPECT and there was a significant difference in perfusion defect according to the regional wall motion (normal or mild hypokinesia in 23 regions: 26.2±10.8%, severe hypokinesia, akinesia or dyskinesia in 16 regions: 78.2±23.7, p〈0.001). These data indicate there is a significant coupling between the degree of myocardial perfusion and the myocardial functional change in coronary artery disease.

휴식기 T1-201/디피리다몰 부하 게이트 Tc-99m-MIBI/24시간 지연 T1-201 SPECT 를 이용한 관상동맥 우회로 수술 후 심근벽 운동 호전의 예측

이명철(Myung Chul Lee),정준기(June Key Chung),이동수(Dong Soo Lee),이원우(Won Woo Lee),김기봉(Ki Bong Kim),여정석(Jeong Seok Yeo),김석기(Seok Ki Kim) 대한핵의학회 1998 핵의학 분자영상 Vol.32 No.6

N/A Purpose: Using rest T1-201/dipyridamole stress Tc-99m-MIBI/24 hour T1-201 SPECT, we investigated the predictive values of the markers of the stress-rest reversibility (Rev), T1-201 rest perfusion (Rest), T1-201 24 hour redistribution (Del) and Tc-99m-MIBI gated systolic thickening (Thk) for wall motion improvement after coronary artery bypass surgery. Materials and Methods: In 39 patients (M:F=34:5, age 58±8), preoperative and postoperative (3 months) SPECT were compared. 24 hour delayed SPECT was done in 16 patients having perfusion defects at rest. Perfusion or wall motion was scored from 0 to 3 (0:normal to 3:defect or dyskinesia). Wall motion was abnormal in 142 segments among 585 segments of 99 artery territories which were surgically revascularized. Results: After bypass surgery, ejection fraction increased from 37.8±9.0% to 45.5±12.3% in 22 patients who had decreased ejection fraction preoperatively. Wall motion improved in 103 (72.5%) segments among 142 dysfunctional segments. Positive predictive values (PPV) of Rev, Rest, Del, and Thk were 83%, 76%, 43%, and 69% respectively. Negative predictive values (NPV) of Rev, Rest, Del, and Thk were 48%, 44%, 58%, and 21%, respectively. Rest/gated stress/delay SPECT had PPV of 74% and NPV of 46%. Though univariate logistic regression analysis revealed Rev (p=0.0008) and Rest (p=0.024) as significant predictors, stepwise multivariate test found Rev as the only good predictor (p=0.0008). Conclusion: Among independent predictors obtained by rest T1-201/stress gated Tc-99m-MIBI/delayed T1-201 myocardial SPECT for wall motion improvement after bypass surgery, stress-rest reversibility was the single most useful predictor.