1. A Study on the Determination of Scan Speed in Whole Body Bone Scan Applying Oncoflash Gwang Gil Yang Department of Nuclear Medicine, Asan Medical Center, Seoul, Korea

2. Introduction Whole Body Bone Scan Radiopharmaceutical Injection Wholebody Scan (required about 15mins) 3~4 hrs delay

3. Purpose Save of scan time Maintenance of Image quality Oncoflash Application Proper Criteria

4. Materials and Method Quantitative evaluation Classified by the total counts - under 800K, over 800K, 900K, 1,000K, 1,500K, and 2,000K. Duration / Subject - July, 2008 / 329 patients Correlation evaluation Correlation analysis - Total counts (30cm/min) and PPM counts Duration / Subject – August, 2008 / 152 patients FWHM evaluation FWHM comparison with 4-Quadrant bar phantom - before and after applying the Oncoflash

5. Materials and Method Equipment / Collimator SIEMENS Symbia T2, E.CAM Signature LEHR Collimator Analysis program Syngo MI Application : Series FWHM Proc SPSS 12.0 Matrix size : 256 x 1024 / Window center : 140kev Window width : ±15% Acquisition Parameter

6. Materials and Method Definition of PPM Counts (Kilo Counts/sec, kcts/s)

7. Materials and Method FWHM measurement

8. Results Scan Speed : 30 cm/min Scan Speed : 15 cm/min Not applied Applied Not applied Applied Quantitative evaluation Total Counts - under 1,000K – : coarse particles and increased noises. (* Same Patient)

9. Results Total Counts (K)Geometric Mean ± SD (K)PersonRatio ~ 800762 ± 3382.4% 17.6 % 800 ~ 900851 ± 27206.1 % 900 ~ 1000953 ± 29309.1 % 1000 ~ 15001228 ± 14019759.9 % 82.4 % 1500 ~ 20001699 ± 1486620.1 % 2000 ~2294 ± 27182.4 % Total329100.0 % Quantitative evaluation Total Counts - under 1,000K – : coarse particles and increased noises. The Percentage according to Total Counts

10. Results FWHM Value after applying the Oncoflash : PPM counts of under 3.6K, were higher. : Whereas over 3.6K, were lower. FWHM evaluation (kcts/s) FWHM Comparison of FWHM Value between Applied and Not-applied Oncoflash

11. Results PPM counts (KiloCounts/sec) Total Counts ± SD (K)PersonRatio 2.5 ~ 3.0K965±173K 1617.8% 3.1 ~ 3.5K1084±154K 3822.4% 3.6 ~ 4.0K1242±186K 2218.4% 4.1 ~ 4.5K1359±170K 3117.1% 4.6 ~ 5.0K1405±184K 2010.5% 5.1 ~ 6.0K1640±376K 1810.5% 6.1 ~ 7.0K1771±324K 41.3% 7.1K ~1972±385K 32.0% Total 152100.0% Correlations between PPM counts and Total counts : strong correlation (r=.775, p<.01). Correlation evaluation Correlation between PPM Counts and Total Counts

12. Results (kcts/s) Correlations between PPM counts and Total counts : strong correlation (r=.775, p<.01). Correlation evaluation Total Counts Correlation between PPM Counts and Total Counts

13. Results PPM countWholebody count PPM count Pearson correlation coefficient 1.775** significance probability.000 Total sum of square, cross product 147/05135666.745 covariance.974236.204 N152 Wholebody count Pearson correlation coefficient.775**1 significance probability.000 Total sum of square, cross product 35666.7451438036 covariance236.20495291.627 N152 Correlations between PPM counts and Total counts : strong correlation (r=.775, p<.01). Correlation evaluation Pearson Correlation Coefficient between PPM Counts and Total Counts

14. Conclusion PPM counts - over 3.6K - & Total counts - over 1,000K - - The image applying the Oncoflash was similar in quality to raw image (not applying Oncoflash). - Reduce scan time without any damage on the image quality. Total counts - under 1,000K – - Oncoflash is applied, Image quality were decreased. - Recommended to perform the re-image in the scan speed of 15cm/min.

15. Thank You