PET/CT 검사에서 Stomach의 추가 촬영을 줄이기 위한 수분 섭취의 유용성

이승환,배성복,정병곤,이규찬,이광철,배원규,Lee, Seung-Hwan,Bae, Seong-Bok,Jeong, Byeong-Gon,Lee, Gyu-Chan,Lee, Gwang-Cheol,Bae, Won-Gyu 대한핵의학기술학회 2011 핵의학 기술 Vol.15 No.1

암 환자의 영상에서 stomach의 병변과 분비물을 구분하기란 쉽지 않다. 이 연구의 목적은 검사 전 충분한 수분 섭취로 stomach의 병변과 분비물의 분별력을 높임으로서 추가 촬영을 줄이기 위하여 시행하였고 본 연구는 총 228명의 암 환자로 2010년 8월 18일부터 2010년 9월10일까지 진행하였으며, 2010년 8월 18일부터 2010년 8월 31일까지는 수분섭취 제한환자가 115명이었고, 2010년 9월 1일부터 2010년 9월 10일까지는 촬영 직전 수분을 500 cc 정도 섭취한 후 검사를 진행한 환자로 113명이었다. 이 검사를 시행한 결과 전체 암 환자 228명을 대상으로 촬영 수분 섭취 제한 환자는 총 115명이고, 이중 추가 촬영이 없는 환자가 89명이었고, stomach 추가 촬영을 진행한 환자가 13이었으며, 기타 추가 촬영을 진행한 환자는 13명이었다. 그리고 촬영 직전 수분을 500 cc 정도 섭취한 후 검사를 진행한 환자 113명 중 추가 촬영이 없는 환자가 109이었고, stomach 추가 촬영을 진행한 환자가 1명이었으며, 기타 추가 촬영을 진행한 환자는 3명에 해당하였다. 이와 같은 결과로도 수분을 500 cc 정도 섭취하고 검사를 진행한 환자에게서 추가 촬영이 줄었음을 알 수 있었으나, 정확한 유의성을 알기 위하여 pearson의 chi-square test를 시행한 결과 유의확률이 0.05보다 작은 0.001이었으므로 두 집단은 유의한 관련성이 있음을 알 수 있고 최소 기대빈도가 6.94로서 5보다 작은 기대빈도가 없었으므로 pearson의 정확한 검정을 할 필요는 없었고, 위의 연구로 인하여 물을 검사 직전 약 500 cc 정도 섭취하고 촬영을 진행하면 stomach 추가 촬영을 현저히 줄일 수 있으며 기타 추가 촬영 또한 줄일 수 있음을 알 수 있었고 검사 지연 시간 또한 줄일 수 있을 것으로 사료된다. Purpose: With the introduction of PET since 1994, test methods have made rapid progress. Accordingly, the studies on the diagnosis and treatment of cancer as well as treatment response evaluation PET test are useful. However, it is difficult to divide stomach lesions and secretion. The purpose of this study is to reduce additional shooting by dividing lesions and secretion of stomach. Materials and Method: This study aiming at total 228 cancer patients was conducted from Aug 18 to Sep. 10, 2010. Among them, 115 patients had a test without water intake before shooting from Aug. 8 to 31 and 113 had a test after drinking 500 cc water right before shooting from Sep. 1 to 10 The Discovery ST PET/CT (GE Healthcare, USA) was used, and pearson's chi-square test was conducted to analyze significance through SPSS (Ver.18). Results: Among the total 228 cancer patients, there were 115 who had a test without water intake before shooting, 89 who had no double additional shooting, 13 who had stomach additional shooting and 13 who had other additional shooting. In addition, 109 had no additional shooting among 113 who had a test after taking 500 cc water, 1 had stomach additional shooting and 3 had other additional shooting. According to the findings above, the patients who had a test without water intake show reduced additional shooting, but for more exact significance, pearson's Chi-square test was carried out and the significance percentage was 0.001 that is smaller than 0.05, which means two groups have a significant relationship. As the minimum expectation frequency was 6.94 and there was no expectation frequency smaller than 5, so that it doesn't need to carry out pearson's exact verification. Conclusion: The above analysis has found that if one drinks 500cc water before the test, not only stomach additional shooting but also other additional shooting can be dramatically reduced, and test delay can be also reduced.

병원종사자의 VDT증후군 자각증상과 건강영향에 관한 연구

이승환,정병곤,이규찬,이광철,배성복,Lee, SeungHwan,Jeong, Byeong Gon,Lee, Gyu Chan,Lee, Gwang Cheol,Bae, Seong Bock 대한핵의학기술학회 2012 핵의학 기술 Vol.16 No.2

Purpose : This study aims to examine hospital employees' subjective symptoms of VDT syndrome (Video display terminal syndrome) and figure out their effects on health conditions and correlations. Materials and Methods : This study used a structured self-administering questionnaire and gained data from 125 subjects. The questionnaire consists of total 62 questions, and they went through real number, percentage, ${\chi}^2$-terst, t-test, one-way ANOVA, and logistic regression analysis. Results : Regarding the difference in the types of subjective symptoms of VDT syndrome by jobs, there was statistically significant difference in ophthalmic symptoms, systemic symptoms, and musculoskeletal symptoms. About the correlation between the subjective symptom points of VDT syndrome by the types of symptoms, there was statistically significant correlation all in skin trouble, backache, upper limb muscle pain, lower limb muscle pain, fatigue in the head and eyes, and depression or anxiety disorders. There was significant correlation between the subjective symptom points of VDT syndrome and subjective health conditions. Conclusion : Hospital employees' subjective health conditions had significant correlation with subjective symptom points of VDT syndrome. This result shows that as radiologists' and also other hospital employees' working conditions change into VDT environment, VDT syndrome gradually appears more and more. This implies that it is needed to designate not only radiologists but also all the other hospital employees as jobs exposed to the working environment of VDT syndrome and provide preventive measures, education, and publicity for it afterwards.

동적신장검사에서 저선량을 사용한 신장검사의 재현성 평가

이재상,이규찬,이승환,배성복,박종엽,Lee, Jaesang,Lee, Kyuchan,Lee, Seunghwan,Bae, Seongbok,Park, Jongyeop 대한핵의학기술학회 2016 핵의학 기술 Vol.20 No.1

동적신장검사는 신장기능을 영상화하는 대표적인 방법이다. 동적신장검사에서 저선량 방사성의약품의 사용으로 기존 동적신장검사와 저선량을 사용한 신장검사의 비교를 통한 동적신장검사의 재현성을 평가해 보기로 했다. 본 비교실험을 통해 재현성이 우수할 경우 환자에 투여하는 방사선량을 줄인 동적신장검사법을 활용하고 환자의 피폭을 줄이고자 한다. 감마카메라 장비로는 Orbiter, SymbiaE (Siemens, Germany)를 사용하였고, 2013년 1월부터 2014년 2월까지 370 Mbq (10mCi)을 사용한 환자와 동일 환자 중 2014년 3월부터 2015년 7월까지 185 Mbq (5 mCi)을 사용한 환자를 대상으로 $^{99m}Tc-DTPA$사용 검사 21명과 $^{99m}Tc-MAG_3$사용 검사 20명 총 41명을 대상으로 데이터를 선별하였다. 결과 영상의 Renogram에서 Peak 지점의 프레임을 선택하여 신장의 관심영역과 배후방사능의 관심영역을 설정하고 K/B ratio를 구하여 비교하였다. $^{99m}Tc-DTPA$를 사용한 검사에서 370 Mbq을 사용하였을 때의 K/B ratio는 평균 $5.67{\pm}0.8$이었고, 185 Mbq을 사용하였을 때는 평균 $5.62{\pm}0.87$로 큰 차이를 보이지 않았다. $^{99m}Tc-MAG_3$를 사용한 검사에서도 신장/배후방사능 비는 370 Mbq을 사용 시 평균 $14.95{\pm}2.58$과 185 Mbq을 사용 시 평균 $14.56{\pm}2.02$로 큰 차이를 보이지 않았다. Paired sample t-test결과 p-value는 $^{99m}Tc-DTPA$ 0.566, $^{99m}Tc-MAG_3$ 0.363로 같은 비교집단 간 차이점이 없음을 확인하였다. 동일 환자를 대상으로 선량을 370 Mbq에서 185 Mbq로 줄였을 때의 동적신장검사의 재현성은 우수한 것으로 확인 되었다. 저선량 동적신장검사는 기존 감마카메라의 성능 개선 없이 재현성이 우수한 결과를 얻을 수 있고 환자의 피폭 또한 줄일 수 있을 것으로 사료된다. Purpose Dynamic kidney scan is a typical imaging technique that visualizes kidney function. Reproducibility of dynamic kidney scans has been evaluated by comparing low-dose kidney scans with low-dose radiopharmaceutical and standard dynamic kidney scan. With this comparative study, if reproducibility is superb, the dynamic kidney scan method with reduced radioactivity to patients is to be utilized and radiation exposure to patient is to be reduced. Materials and Methods For gamma camera, Orbiter, SymbiaE (Siemens, Germany) was used. Among patients who had used 370 Mbq (10 mCi) from January of 2013 to February 2014 and other patients who had used 185 Mbq (5 mCi) from March of 2014 to July of 2015 with identical condition, 21 subjects using DTPA and 20 subjects using $MAG_3$, 41 subjects in total, had been selected as subjects for data. From renogram of the result image, frame of the peak point was selected. Then, region of interest of kidney and background had been selected and Kidney to Background Ratio has been calculated for comparison. Results In tests using DTPA, kidney to background ratio when using 370 Mbq was $5.67{\pm}0.8$ at average while it was $5.62{\pm}0.87$ when using 185 Mbq, which didn't show much difference. Also in the tests using $MAG_3$, kidney to background ratio when using 370 Mbq was $14.95{\pm}2.58$ at average and $14.56{\pm}2.02$ in 185 Mbq, which neither showed much difference. In paired sample t-test, p-value was 0.566 in DTPA and 0.363 in $MAG_3$, which confirmed that there was no difference between the groups. Conclusion In identical patients, when dose was decreased from 370 Mbq to 185 Mbq, reproducibility of dynamic kidney scan was proven to be excellent. Low-dose Dynamic kidney scan can achieve results with fine reproducibility without improvement in performance of gamma camera and is expected to reduce radiation exposure to patient.