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갑상선암 환자에서 방사성옥소 진단스캔과 치료 후 스캔의 비교 및 임상경과
염하용,배상균,이석모,황경훈 대한핵의학회 2000 핵의학 분자영상 Vol.34 No.1
Purpose: We compared the first postoperative diagnostic and post-therapy scans of patients who received therapeutic doses of I-131, to investigate the difference in clinical outcomes between patients with concordant findings of diagnostic and post-therapy scans and patients with discrepant (more lesions in post-therapy scan) findings. Materials and Methods: The first postoperative diagnostic and post-therapy radioiodine scans of one hundred forty three patients with well differentiated thyroid carcinoma were reviewed. Diagnostic scans were obtained following ingestion of 185 MBq of I-131 and post-therapy scans were obtained after therapeutic dose of 3.7∼9.3 GBq of I-131. Successful ablation was defined as no radioiodine uptake on diagnostic radioiodine scan and normal range of serum thyroglobulin level (<10 ng/ml) during serum TSH elevation. Results: Discrepant scan findings were noted in 25 (17.5%) patients. Twenty-two patients (15.4%) showed more lesions in post-therapy scan and 3 patients (2.1%) showed stnning effect. Nine (64.3%) of 14 patients with distant metastasis revealed metastatic lesion(s) only on post-therapy scan. Stunning effect was considered as sublethal damage in 1 patient and treatment by a diagnostic dose in 2 patients. Ablation was achieved in 52.4% (75/143) of all patients. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. Conclusion: There were 17.5% difference between diagnostic and post-therapy scan findings when using 185 MBq of I-131 as a diagnostic dose. However, 64.3% of distant metastases were revealed only on post-therapy scan. Ablation rate and mean cumulative radioiodine dose were not different statistically between concordant and discrepant groups. The stunning effect was considered as not only sublethal damage but also treatment by a small diagnostic dose of radioiodine. (Korean J Nucl Med 2000;34: 22-9)
Tc-99m HMPAO Brain SPECT for ischemic strokes
염하용 고신대학교(의대) 고신대학교 의과대학 학술지 1991 고신대학교 의과대학 학술지 Vol.7 No.1
-Abstract- Major advantage of Tc-99m HMPAO SPECT was easy availability at every Nuclear Medicine laboratories and high quality of images by many favorable character of Tc-99m labeled agent. 8 patients of non ischemic neurologic disorders and 15 patients of neurosis as controls and 38 patients of ischemic strokes were studied for how much decrease % of activity (DPA) is abnormal for ischemic strokes. Mean DPA of neurologic control compared to contralateral side was 5.7±4.14% and mean DPA of neurotic control patients was 10.3±2.3%. Higher than DPA 15% was counted as abnormal (above mean value+2 s.d.). Detection sensitivity of ischemic strokes was 100%. DPA more than 20% was adequate for prediction of ischemic strokes with acceptable false negative rate and DPA more than 15% for TIA with expected high false positive rate. DPA more than 30% was prone to be complete strokes (prediction 90%) and would be critical level for prospect of prognosis. The complete strokes with cerebral atrophy and/or by old infarcts were prone to show the hypoperfusion less contrast to have DPA less than 20%. Tc-99m HMPAO SPECT was found to have much superiority in detection of ischemic strokes, compared to XCT (detection rate : 46.4% ) and invasive digital angiography ( detection rate : 58.8%).