뇌종양의 진단에 Thallium-201 SPECT의 유용정 - 임상 분석 -

강신혁,정용구,최재걸,이기찬,이훈갑 대한신경외과학회 1998 Journal of Korean neurosurgical society Vol.27 No.8

유방 종괴의 감별진단을 위한 탈륨 스캔의 유용성

배상균,염하용,이충한,최경현 고신대학교 의과대학 1995 고신대학교의과대학부설연구소논문집 Vol.1 No.-

유방 종괴의 감별진단을 위한 탈륨 스캔의 유용성

염하용(Ha Yong Yum),배상균(Sang Kyun Bae),이충한(Chung Han Lee),최경현(Kyung Hyun Choi) 대한핵의학회 1994 핵의학 분자영상 Vol.28 No.2

N/A The purpose of this study is to evaluat.e thallium scanning as a potential test in differentiating malignant from benign lesions of breast. Thirty-one female pat,ients underwent thallium scan of the breast. After intravenous injection of 74-111 MBq(2-3 mCi)of thallium-201, anterior and lat,eral images were obtained. We cornpared thallium scans with pathological results. Of 11 patiens with breat cancers, 10 cases(90.9%) were detected using thallium scan. Thallium scan obtained in one pat,ient who had breast cancer but received several cycles of chemotherapy did not show thallium uptake. The smallest detect,able cancer was 1.5cm in diameter. ln contrast, there is no thallium accumulation in breasts of 17 of 20 patients with benign dis ease(85%), Three cases of 13 fibrocystic disease show thallium uptake in their breast. In conclusion, thallium scan is an effective test in differentiating benign from malignant lesion.

Value of Thallium-201 SPECT and SPECT/CT Brain Imaging in Differentiating Malignant From Nonmalignant Lesions: A Comparative Case-Series Study With Pathologic and/or Clinical Correlation

( Nicole Girlyn T. Pang ),( Julette Marie F. Batara ),( Lara Triccia C. Luistro ),( Christianne V. Mojica ),( Allan Jay C. Domingo ) 대한뇌종양학회·대한신경종양학회·대한소아뇌종양학회 2023 Brain Tumor Research and Treatment Vol.11 No.4

Background Thallium-201 single-photon emission computed tomography/computed tomography (SPECT/CT) brain scan is an imaging modality which can be done to differentiate between malignant and nonmalignant lesions among patients with nonconclusive findings on conventional neuroimaging. This study describes the results of thallium-201 SPECT/CT brain imaging and relate it to histopathologic and/or clinical findings and evaluate the value of thallium-201 SPECT/CT brain imaging in differentiating malignant from nonmalignant lesions. Methods This is a retrospective case series study of 10 patients with cerebral lesions who underwent thallium-201 SPECT/CT brain imaging in a hospital in the Philippines from 2010 to 2021. Results A total of 10 patients underwent thallium-201 SPECT/CT brain scan. Six had negative results while 4 had positive results. All of the patients who had positive results were found to have malignancy, whether recurrent or newly diagnosed. All of the patients with negative scan were found to have either an infectious and inflammatory disease and responded to treatment albeit in different degrees. Two of the 10 patients underwent biopsy whose results were consistent with the thallium-201 SPECT/CT brain scan results. Conclusion Thallium-201 brain scan combined with SPECT and SPECT/CT has been demonstrated to be useful in distinguishing malignant from nonmalignant lesions and is more cost-effective versus other imaging techniques. The findings in this study support the role of thallium scintigraphy in the diagnosis of patients with brain lesions most significantly when there is a need to differentiate between a malignant and benign condition.

변형 협심증에서 운동부하검사 , Thallium - 201 심근관류검사 및 Holter 심전도 검사의 다양성

최석주(Seok Joo Choi),서홍석(Hong Seok Suh),오동주(Dong Joo Oh),박정의(Jeong Euy Park),노영무(Young Moo Ro) 대한내과학회 1989 대한내과학회지 Vol.36 No.3

N/A Variant angina is defined as angina occurring at rest with reversible ST-segment elevation of the ECG. However, the underlying coronary pathology of variant angina can be either a spasm of the coronary artery with fixed stenosis or a spasm of the normal coronary artery. Therefore, the clinical or laboratory features of variant angina may vary according to the underlying coronary pathology. In an attempt to investigate the features of the exercise stress test, Thallium-201 myocardial perfusion scintigraphy (MPS) and Holter ECG monitoring in 14 patients with variant angina were studied. The exercise stress test was positive in 57.1% of patients and negative in 42.9%. There was no relationship between the degree of ST-segment depression and the frequency and severity of attacks of chest pain at rest. Thallium-201 MPS showed reversible perfusion defects in 71.4%. The locations of the perfusion defects were anteroseptal (20%), anterolateral (20%), septal (10%), apical (10%), posterolateral (20%) and inferior walls (20%). Both the exercise stress test and Thallium-201 MPS were positive in 57.1% of patients, which favors the presence of exercise-induced myocardial ischemia due to fixed coronary artery disease. The exercise stress test and Thallium-201 MPS were both negative in 28.6%, and only the Thallium-201 MPS was positive in 14.3%. The Holter ECG during attacks of chest pain at rest showed ventricular tachycardia in 14.3%. The concordance rate of the Holter ECG lead of ST-segment elevation during the attacks of chest pain at rest with the location of the Thallium-201 MPS perfusion defect was 70%, and the discordance rate was 30%. In conclusion, the findings we observed in a limited patient series showed that there was diversity in the features of the exercise stress test and Thallium-201 MPS in patients with variant angina. These results seem to favor the coexistence of fixed coronary artery disease and spasm in a considerable proportion of patients with variant angina.

만성 간 질환에서 경직장 Thallium-201 간 스캔의 임상적 의의 및 방사능 분포 양상

박문승,박근태,김진배,윤병철,최호순,함준수,기춘석,박경남,이민호 大韓消化器病學會 1997 大韓消化器病學會誌 Vol.30 No.4

근골격계 종양에서 탈륨 스캔의 역할

신덕섭 영남대학교 의과대학 2003 Yeungnam University Journal of Medicine Vol.20 No.2

Thallium-201 scintigraphy is used to discriminate the malignant bone tumor from the benign by qualitatively and quantitatively, and to predict the response of preoperative chemotherapy in osteosarcoma, by comparing the changes of thallium uptake ratio after chemotherapy to the tumor necrosis ratio. Thallium-201 scintigraphy scan should be done prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator is usually used for scanning. The patient is injected with 2-3mCi of T1-201 and the early phase is checked in 30 minutes and delayed phase in 3 hours. The scan images are visually evaluated by a blinded nuclear medicine physician. We could evaluate true positive, true negative, false positive and false negative by the comparison of results with those of biopsy, and calculate positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%). For the quantitative analysis of thallium uptake, we drew the region of interest on the tumor side and contralateral normal side as mirror image, and calculated the uptake ratio with dividing the amount of gamma count in tumor side by normal side. We could calculate the percent changes of thallium uptake ratio in early and delayed phase, and compare them to the ratio of tumor necrosis. Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors. We can use T1-201 scan to differentiate the benign from the malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.

만성 간 질환에서 Thallium-201 간 스캔의 단락지수(Shunt Index)와 간 조직 검사 소견에 대한 연구

유영조(Young Jo Yoo),정진웅(Jin Woong Jung),최춘식(Choon Sik Choi),전대원(Dae Won Jeon),이오영(Oh Young Lee),최호순(Ho Soon Choi),윤병철(Byung Chul Yoon),함준수(Joon Soo Hahm),이민호(Min Ho Lee),최윤영(Yun Young Choi),홍은경(Eun Kyun 대한내과학회 2000 대한내과학회지 Vol.58 No.2

N/A Background : The disturbances of portal circulation in chronic liver disease may cause hepatic failure, hepatic encephalopathy and variceal bleeding. The measure of porto-systemic shunt plays a significant role in the management and prognosis of the patients. So we have evaluated the relationship between the shunt index of thallium-201 liver scan and the histological grade and stage of chronic liver disease. Methods : The thallium-201 scintigraphy per rectum was evaluated in 159 patients with chronic liver disease, which were proven with percutaneous liver biopsy. We used the heart to liver activity ratio at 20 minute as shunt index, representing portal-systemic shunt. The two pathologists scored independently hepatitis activity (lobular and porto-periportal activity) and stage (fibrosis). Results : A significant difference was noted between the shunt index and the scores of fibrosis (p<0.001) although this correlation was statistically weak (r=0.26, p=0.008). In cumulative logistic regression test, the shunt index had a effect on the fibrosis (p<0.001) but not on the lobular and porto-periportal activity. Fibrosis was predicted as less than 2 if shunt index was less than 0.24, 3 if more than 0.24 but less than 0.46, 4 if more than 0.46. Conclusion : The shunt index of thallium-201 liver scintigraphy correlated only with fibrosis not with lobular and porto-periportal activity. As the fibrosis progresses in chronic liver disease, portal hypertension becomes more severe and the shunt index increases. Thallium-201 liver scan may be useful for evaluation of hepatic fibrosis instead of invasive liver biopsy in predicting the histological stage (fibrosis) of advanced chronic liver disease.(Korean J Med 58:152-160, 2000)

고립성 폐결절의 악성 및 양성 감별진단에 Thallium - 201 폐스캔의 가치

김창호(Chang Ho Kim),한춘덕(Chun Duk Han),차승익(Seung Ick Cha),박재용(Jae Yong Park),정태훈(Tae Hoon Jung) 대한내과학회 1995 대한내과학회지 Vol.49 No.5

N/A Objectives: The clinical usefulness of thallium-201 lung scintigraphy as noninvasive method in distinguishing pulmonary malignant lesisons from benign conditions had been reported. We are aimed to evaluate the clinical usefulness of thallium-201 lung scintigraphy in patients with solitary pulmonary nodule or mass. Methods: Planar thallium-201(201TI) lung scintigraphies were obtained 1hour after injection of 2mCi of 201TI in 38 patients with solitary pulmonary nodule or mass found on chest radiograph, which were confirmed by histological or bacteriologic methods. And we compared differences of uptake between malignant and benign lesions. Results: Abnormal focal accumulations were demonstrated in 20cases of 25primary malignant neoplasms and in H cases of 13benign conditions. No definite uptake was seen in 5cases of malignant lesions. Positive abnormal uptake was observed in pneumonia and lung abscess as well as active pulmonary tuberculosis, whereas inactive pulmonary tuberculosis, demonstrated no uptake. After medical treatment in patients with benign disease and increased focal uptake, follow-up scintigraphy with 201TI showed disapperence of previous abnormal accumulations. Conclusion: These results suggest that both primary lung cancer and benign inflammatory lesions can show uptake of 201TI and, although thallium-201 lung scintigraphy may be helpful in the evaluation of tuberculous activity, it is not useful in distinguishing malignant lesions from benign conditions.

급성심근경색에서 Troponin T 와 경색의 크기와의 상관관계

서창희(Chang Hee Suh),김한수(Han Soo Kim),강한걸(Han Geol Kang),신준한(Joon Han Shin),탁승제(Seung Jae Tahk),이승호(Seong Ho Lee),최병일(Byung Il William Choi) 대한내과학회 1997 대한내과학회지 Vol.52 No.1

N/A Objectives: The estimation of infarct size has been important in evaluation of prognosis of the patients who had acute myocardial infarction. The infarct size estimated by the thallium-201 SPECT has been known to correlate with the prognosis of patient. The enzymatic estimation by the total release of creatine kinase isoenzyme MB(CK-MB) has been widely used in estimating infarct size clinically, but inconvienent and not cardiospecific. Recently, serum troponin T, cardiospecific myofibrillar protein, has been used in the diagnosis of acute myocardial infarction, and used in the estimation of reperfusion following myocardial infarction. To assess the role of the late troponin T peak concentration on the estimation of infarct size, this prospective study was carried out. Methods: The patients with acute myocardial infarction who were admitted, within 48hours after the onset of chest pain, to Ajou University Hospital between April 1995 and August 1995 were evaluated. All patients were divided into anterior and inferior infarct and checked serum troponin T and CK-MB serially, and underwent stress Thallium-201 SPECT 1 week after infarction, In each group, we assessed the correlation of the late toponin T peak concentration, the total release of CK-MB, and the infarct size estimated by thallium-201 single photon emission computed tomography(SPECT). Results: 1) The eligible subjects consisted of 22 patients (17 men and 5 women), and age ranged from 29 to 77 years(mean 57.8±12.5 years). 2) The mean arrival time to the hospital after the onset of chest pain was 15.5±13.2 hours. The 19 patients had at least one risk factor for coronaryartery disease. 3) The late troponin T peak concentration and the total release of CK-MB in patients with anterior infarction were not different from those with inferior infarction. The infarct size estimated by the thallium-201 SPECT in patients with anterior infarction was larger than patients with inferior infarction The left ventricular ejection fraction in anterio infarction was lower than inferior infarction. 4) The late troponin T peak concentration ha: positive correlation with the infarct size estimated by the thallium-201 SPECT in the total patients, and both patients with anterior infarction and inferio infarction. 5) The total release of CK-MB correlated with the infarct size estimated by the thallium-20 SPECT in the total patients, and the patients of inferior infarction. Conclusion: The late troponin T peak concentration was more accurate than the total release o CK-MB in the estimation of infarct size. Therefore, when the patient arrived to the hospital less than 48hr after the onset of chest pain, the late troponin T peak concentration is useful in the decision and evaluation of therapeutic intervention and in the prediction of prognosis.