목적 : 기존의 fan-beam을 이용한 triple detector system에서 parallel collimator를 이용한 dual detector system으로 변화에 있어 acquisition과 processing 부분에서 발생할 수 있는 여러 가지의 변수를 phantom과 volunteer test를 통하여 실험해 보았다. 1 day protocol brain spect를 위하여 parallel collimator에서만 적용되는 OSEM2D와 OSEM3D의 비교 분석을 중점으로 하였고, 모든 연구는 동등한 검사시간으로 fan-beam을 사용하였던 Triple gamma camera보다 parallel을 사용한 dual camera에서 보다 우수한 영상을 구현하고자 하는 목표를 지향하였다. 실험재료 및 방법 : Normal time scan과 short time scan을 실시하였고, collimator 변화에 따른 영상의 변화도 알아보았다. Jaczack performance phantom과 Body IEC phantom을 이용하여 SNR과 contrast를 평가해보았고 Hoffman 3D phantom의 실험을 거쳐 volunteer test를 실시하였다. 결과 : Normal time과 short time의 비교에서는 FLASH3D를 제외한 OSEM2D와 FBP는 분석방법으로 부적합하였다. LEAP는 resolution과 sharpness 등 전체적인 영상의 질이 기존의 fan-beam을 이용한 영상과 유사하였고, LEUHR은 감도의 저하로 1 day protocol을 적용하기 위한 scan time에는 부적합하였다. 재구성법의 비교에서는 Flash-3D를 이용한 결과들이 기존의 FBP와 OSEM-2D보다 월등히 정확함을 정성적으로 확인하였다. 결론 : OSEM3D 재구성법으로 Dual detector system에서의 1 day protocol brain SPECT 시 Fan-beam보다 sensitivity가 떨어지는 parallel collimator의 단점을 보완하면서 영상의 질 또한 de-noising과 scatter correction, resolution recovery 등의 효과를 얻을 수 있으므로 1 day protocol brain SPECT의 검사의 적용에 유용할 것으로 사료된다. 그러나 이러한 half-time method라 제공되는 다양한 프로그램의 임상적용에 대한 광범 위한 연구가 현실적으로 필요하며 향후 계속적인 연구가 기대되는 바이다.
Purpose: Brain SPECT study is more sensitive to motion than other studies. Especially, when applying 1-day subtraction method for Diamox SPECT, it needs shorter study time in order to prevent reexamination. We were required to have new study condition and analysing method on dual detector system because triple head camera in Seoul National University Hospital is to be disposed. So we have tried to increase image quality and make the dual and triple head to have equivalent study time by using a new analysing program. Materials and Methods: Using IEC phantom, we estimated contrast, SNR and FWHM. In Hoffman 3D brain phantom which is similar with real brain, we were on the supposition that 5% of injected doses were distributed in brain tissue. To compare with existing FBP method, we used fan-beam collimator. And we applied 15 sec, 25 sec/frame for each SEPCT studies using LEHR and LEUHR. We used OSEM2D and Onco-flash3D reconstruction method and compared reconstruction methods between applied Gaussian post-filtering 5mm and not applied as well. Attenuation correction was applied by manual method. And we did Brain SPECT to patient injected 15 mCi of $^{99m}Tc$-HMPAO according to results of Phantom study. Lastly, technologist, MD, PhD estimated the results. Results: The study shows that reconstruction method by Flash3D is better than exiting FBP and OSEM2D when studied using IEC phantom. Flowing by estimation, when using Flash3D, both of 15 sec and 25 sec are needed postfiltering 5 mm. And 8 times are proper for subset 8 iteration in Flash3D. OSEM2D needs post-filtering. And it is proper that subset 4, iteration 8 times for 15sec and subset 8, iteration 12 times for 25sec. The study regarding to injected doses for a patient and study time, combination of input parameter-15 sec/frame, LEHR collimator, analysing program-Flash3D, subset 8, iteration 8times and Gaussian post-filtering 5mm is the most appropriate. On the other hands, it was not appropriate to apply LEUHR collimator to 1-day subtraction method of Diamox study because of lower sensitivity. Conclusions: We could prove that there was also an advantage of short study time effectiveness in Dual camera same as Triple gamma camera and get great result of alternation from existing fan-beam collimator to parallel collimator. In addition, resolution and contrast of new method was better than FBP method. And it could improve sensitivity and accuracy of image because lesser subjectivity was input than Metz filter of FBP. We expect better image quality and shorter study time of Brain SPECT on Dual detector system.
