[en] This proceedings contains articles of 2nd Korea-China Congress of Nuclear Medicine and 2000 spring meeting of the Korean Society Nuclear Medicine. It was held on May 17-19, 2000 in Seoul, Korean. This proceedings is comprised of 6 sessions. The subject titles of session are as follows: general nuclear medicine, neurology, oncology, radiopharmacy and biology, nuclear cardiology, nuclear cardiology: physics and instrumentation and so on. (Yi, J. H.)

[en] To investigate the characteristics of expression and distribution of 5 subtypes of somatostatin receptors (SSTR1-5) in lung cancer. With (α-³⁵S) dATP labeled oligonucleotide of the 5 SSTR subtypes as probe, using in situ hybridization, patterns of mRNA expression were detected of lung cancer tissues of 2 cases that fell in varied pathologic types. Additionally, Leica was employed to semi-quantitatively analyze density of the expression. Patterns of SSTR1∼5 expression in lung cancer were as follows: SSTR2 expression was dominant in SCLC while in such NSCLC as adenous and squamous SSTR1 expression was stronger than that of the other 4 subtypes; In density of SSTR1∼ 5 expression in lung cancer, NSCLC was higher than SCLC (p<0.01). Even though patterns and density of expression of SSTR subtypes in lung cancer showed heterogeneity in pathohistologic types, as in SCLC, in NSCLC SSTR expression occurred as well. Therefore, it has positive prospects for somatostatin analog-oriented agents to be used in treatment of both of the lung cancers

[en] We evaluated the distribution pattern and uptake ratio of bone marrow using anti-NCA-95 monoclonal antibody in patients with various hematologic malignancy. Bone marrow immunoscintigraphy was performed on 50 patients; 11 with acute myelogenous leukemia (AML), 12 with acute lymphocytic leukemia (ALL), 15 with lymphoma (LYM) and 2 myelogenous syndrome (MDS). The bone marrow activity was categorized into four groups (G): I, II, III, IV. The degree of bone marrow extension was 0 in Gl, 7 in GII, 3 in GIII, 1 in GIV of AML patients; 0 in GI, 5 in GII, 6 in GIII, 1 in GIV of ALL patients; 3 in GI, 11 in GII, I in GIII, 0 in GIV of LYM patients; 1 in G1, 4 in GII, 5 in GIII, 2 in GIV of MDS patients. Bone marrow extension was marked in MDS patients (58% in GIII, GIV), mil in LYM patients (93% in GI, GII) and heterogenous in leukemic (AML, ALL) patients. UR was 5.9±3.6 in AML patients, 7.9±4.6 in ALL patients, 6.3±2.8 in LYM patients and 8.5±4.0 in MDS patients (p=NS). UR of whole patients was 5.4 ±2.6 in GI, 7.1±3.7 in GII, 9.3±3.4 in GIII and 2.1±0.4 in GIV (p=0.003). The pattern of bone marrow extension was different among the disease entities. Activity of central hemopoietic marrow was related to the degree of bone marrow extension, but not to the disease entities. Compensatory response of bone marrow developed at both peripheral and central skeleton in patients with hematologic malignancy

[en] This study evaluated the diagnostic value of radioimmnoimaging (RII) with ⁹⁹Tc labeled monoclonal antibody C50, raised originally against carcinoembryonic antigen (anti-CEA) in various tumors. 152 pathologically confirmed patients with a tumor were imaged prior to surgery with an anti-CEA monoclonal antibody labeled with ⁹⁹Tc. There were 115 patients with ovarian carcinoma, 26 patients with colorectal carcinoma and 11 patients with lung carcinoma. Images were acquired at 3-6 h post injection and were analyzed by the double blind method. Images of patients with ovarian cancer were compared with B-ultrasound images. Immunohistochemical staining was performed on all cases of colorectal cancer. All RII images demonstrated excellent contrast, clear lesions, and no serious toxic or other side reactions occurred. Transient chills and fever were observed in 3 cases. This study showed a sensitivity=88.2%, specificity=83.2%, and an accuracy=4.0%. The smallest lesion size detected was 2 x 2 cm. The total combined lesion detection rate for primary, metastatic, and recurrence lesions was 84.4%. We conclude that ⁹⁹Tc labeled anti-CEA MoAb C50 can be used in the diagnosis of colorectal carcinoma, ovarian carcinoma, and lung carcinoma

[en] Eight-interval gating is commonly used in Tc-99m MIBI SPECT. The differences in regional myocardial tracer uptake were not fully evaluated between 8 and 16-interval gated SPECT. The purpose of this study was to compare regional myocardial perfusion and LV functional parameters between 8 and 16-interval gated SPECT in the same subject. 38 patients (mean age 55 years, male:female=23:15) with suspected coronary artery disease underwent rest-gated SPECT twice by 8 frames and 16 frames a cardiac cycle. LV end-diastolic volume (EDV), end-systolic volume (ESV) and ejection fraction (EF) were obtained and we analyzed regional myocardial uptake of end-diastolic images using a 18-segment, 4-point scale of perfusion (0=normal to 3=severe hypoperfusion). The agreement of regional myocardial perfusion between 8 and 16-interval gated SPECT was fairly good (agreement: 87.0%, tau-b: 0.750, p<0.001). The differences in EDV and EF between 8 and 16-interval gated SPECT were small, although statistically significant. The agreement of regional myocardial perfusion between 8 and 16-interval gated SPECT was fairly good and the differences in LV functional parameters were small

[en] Since the first publication of bone scanning in 1961 by Fleming et al, the scope of bone scanning has continuously been expanded, and it has now become one of the most widely used nuclear scans. The successive addition of nuclear angiography, SPECT and pinhole magnification has greatly enhanced the diagnostic feasibility. In particular, pinhole scintigraphy can provide unique information regarding both the anatomy and metabolism or molecular alternations of a variety of skeletal disease. Technically, it is to be noted that pinhole imaging is only means to truly improve the resolution. Simulated magnification techniques or SPECT cannot improve the resolution. SPECT is designed to primarily eliminate overlapping anatomy by sectioning. With the modification of scan technique by using ^99mTc-hydroxydiphosphonate (HDP) and 4-mm pinhole, most planar bone pinhole scintigraphy can be completed within 15-20 min. Recently, dual-head planar pinhole scintigraphy and pinhole SPECT have been developed. The former mode can yield a pair of high-resolution scans eliminating the blind zone and the latter mode, the hybrid of pinhole magnification and tomography, can portray anatomy and pathology in an amazing detail. Supported by the future development of new hard soft wares, and applied to small anatomical structures and subtle pathology, these scintigraphic modes are expected to open a new horizon in the diagnosis of musculoskeletal diseases

[en] Since the routine use of MRI or angiography to evaluate treatment response in congenital vascular malformation (CVM) is limited, we investigated the usefulness of quantitative whole body blood pool scintigraphy (WBBPS) for this purpose. 15 CVM lesions in 11 patients (M:F=5:6, age=2510) that underwent sclerotherapy were included. All patients underwent pre-and post-treatment WBBPS (760 MBq 99mTc-RBC) and MRI. Treatment response was 'improved' or 'not improved' according to follow up MRI results. Blood pool of lesion was quantified from WBBPS as %L/WB (%lesion to WB count) and an improvement index (% Imp) after treatment. The location of CVM was the head (2), upper (4), or lower extremities (9). After treatment, the lesion was improved in 10 and was unimproved in 5 cases, % Imp from follow up WBBPS ranged from 87% to -14%. The amount of improvement was 50% for 3 lesions. 15 ∼ 49% for 6 lesions, and <15% for 6 lesions. %Imp measured with WBBPs showed significant correlation to MRI results (rho=0.70, p<0.01). WBBPS allowed serial simple quantification of blood pool in CVM lesions, which correlated to MRI assessment of treatment response and may thus be useful for further treatment decisions

[en] To evaluate the effect of patient motion on dual head tomography and the distinction between the effects on single and dual head tomography. By setting two heads in 90 degrees orientation, a 90 degrees tomography myocardial perfusion imaging was performed on dual head and a 180 degrees was performed on single head (closed another head). During imaging, a myocardial phantom was moved once along the x and y axial direction at 1 pixel, 2 pixels and 3 pixel, respectively. Raw images were analyzed with a motion detection software and reconstructed images were analyzed with polar map. (1) Motion detection in dual head imaging, three motions were detected on once motion along y direction and multi-motions were also detected on once motion along x direction but the motion extent was related to the angle 0 between the detector plane and the x direction. (2) Polar map analysis: In y direction, 2 pixels motion on single head and 1 pixel motion on dual map analysis: In y direction, 2 pixels motion on single head and 1 pixel motion on dual head could cause count decrease n apex. In x direction, the effect extent related to one pixel motion at 315 degrees could resulted in count decrease in wall on single head and in apex and wall on dual head. But at 270 degrees motion the effect was slight on single head. The effect of patient motion on dual head tomography myocardial perfusion is more striking than on single head

[en] The purpose of this study was to estimate the radiation dose to thyroidectomized patients with differentiated thyroid cancer after I-131 therapy. The absorbed dose delivered y I-131 to a thyroid remnant was estimated by Monte Carlo code EGS4. Using the HPGe whole body counter (GC2520, Canberra 1997), we estimated the whole body dose to the 30 postsurgical patients with remnants (7) or without remnants (23) after administration of I-131 (1.85 ∼ 7.40 GBq). We acquired the whole body count of I-131 thyroid therapy patients in 8 minutes, and was calculated the effective whole body dose using CINDY(Code for Internal Dosimetry)code (ver1.4). We used the revised the I-131 kinetic model in thyroidectomy. Estimated initial dose rate 2.78 Gy/hr to 5 g, 4.13 Gy/hr to 10 g of tissue. To the patients without remnants, whole body dose was 1.89±0.59 rem/GBq. These results are different to those derived from the ICRP-54 for euthyroid model (3.39±1.08 rem/GBq). In the case of thyroidectomy, the ICRP-54 lodine kinetic model may not be appropriate. So the additional studies are in progress to revised I-131 kinetic model to thyroidectomized patients

[en] It is well known that the image by pinhole collimator (PH) has more good resolution than that by high resolution parallel-hole collimator (HRPH). We performed this study to compare PH and HRPH for the detection of metastatic cervical lymphadenopathy (MCL) from remnant thyroid tissue (RT). One hundred forty three studies in 71 patients (M :F=12: 59, age 43.3±13.9 yrs) were included in our investigation. In 111 of 143 studies which were received 1110 MBq of I-131, HRPH and PH were performed 3 days after intake. PH were obtained with 6 mm aperture in size and for 10 minutes. Markers were placed to the submental and sternal notch region. We compared two image modality for the detection of MCL and RT in cervcal region. All of the patients were revealed well differentiated thyroid cancer (papillary: follicular=68: 3). Sixty five of 111 studies (58.6%) showed concordant results and 46 of 111 (41.4%) showed discordant results. In the group of discordant result, PH study was more useful for the detection of lesions with RT and MCL 25/46 (54.3%) and 29/46 (63%), respectively. In well differentiated thyroid cancer after surgery, we conclude that PH has more useful value in monitoring of therapeutic response in RT, and provides additive information for the necessity of high dose radioactive iodine therapy in patient with MCL