[Abnormal lung uptake of 123I-BMIPP].

An eighty-one-year-old male patient with a feeling of chest pressure was admitted to our hospital for investigation of the heart. 201T1/123I-BMIPP dual scintigraphy was performed and multiple uptakes of 123I-BMIPP were detected in the lung, but not of 201T1. His chest X-ray and chest CT showed no abnormal lesions in the corresponding regions. There have been no reports that 123I-BMIPP accumulate in the lung. The possible cause of the lung uptake was embolism from aggregated 123I-BMIPP due to cold tempetatures.

Hematoma after femoral arterial blood sampling: incidence, imaging features, and course of hematoma.

OBJECTIVE: This study evaluated the incidence and course of a hematoma occurring after femoral arterial sampling. MATERIALS AND METHODS: We studied 270 patients who underwent computed tomography (CT) including the pelvis and blood gas sampling from femoral artery using a 22-gauge needle during 2010. This population comprised 176 men and 94 women with a mean (SD) age of 54.9 (24.3) years (range, 0-97 years). We evaluated whether hematoma was present at the femoral artery. Size and location of the hematoma, the short-axial luminal diameter of artery contact with the hematoma was also assessed. RESULTS: The CT images showed hematoma around the femoral artery in 128 patients (47.4%); this group comprised 84 men and 44 women with a mean (SD) age of 51.1 (24.1) years (range, 0-92 years). Hematoma was not observed in 142 patients (52.6%; 92 men and 50 women; mean [SD] age, 58.3 [24.2] years; range, 0-97 years). There was no significant difference in age, sex, altered hemostasis, or time between arterial puncture and CT between the 2 groups with or without hematoma. Arterial stenosis of 50% or greater was observed in 7 patients (mean [SD] age, 17.1 [8.97] years; range, 6-31 years; 4 males and 3 females). CONCLUSIONS: Our data revealed a high frequency of small hematoma around the femoral artery is following arterial blood sampling that was independent of bleeding diathesis. No patient progressed to a severe condition, although temporary arterial stenosis did occur.

Imaging findings at the donor site after iliac crest bone harvesting.

OBJECTIVE: Postoperative imaging after iliac crest bone harvesting is commonly performed, but has not been extensively reported in the literature. The objective of this analysis was to investigate the donor site after iliac crest graft harvesting. MATERIALS AND METHODS: Between January and December 2008, 3,450 patients underwent CT, which included the pelvis. Eighty-four patients were found whose iliac crests were harvested. The patient population consisted of 47 male and 37 female subjects ranging from 10 to 80 years old (mean 52.6 years) at the time of iliac bone harvesting. With the inclusion of prior examinations, 188 CT examinations, 17 MR imaging studies, and 19 bone scintigrams were analyzed at various time points after surgery. RESULTS: Computed tomography images demonstrated fluid collections, hematoma, and air at the donor site up to 1 month after bone harvesting. The air then disappeared. Fluid collection decreased in size by 4 months. Scar-like changes at the harvest site and irregular thick cortical bone were observed after 4 months. Later, CT and MR imaging demonstrated small scar-like lesions and cortical irregularities. CONCLUSION: The appearance of harvest site abnormalities depends on the time elapsed after surgery.

Comparison of Alzheimer's disease with vascular dementia and non-dementia using specific voxel-based Z score maps.

OBJECTIVE: We investigated the ability to discriminate between Alzheimer's disease (AD) and vascular dementia (VaD), and between AD and non-dementia using the program "easy Z score imaging system" (eZIS) developed by Matsuda et al., for the diagnosis of very early AD. METHODS: Of 201 patients, we investigated 12 patients with AD, 10 with VaD, and 9 with non-dementia, who underwent brain perfusion single-photon emission computed tomography by technetium-99m ethyl cysteinate dimer (99mTc-ECD) between February 2005 and September 2006. The sensitivity and specificity of the indicators of specific volume of interest (VOI) analysis, namely, severity, extent, and ratio were evaluated for the distinction of AD from VaD and non-dementia. RESULTS: There was a significant difference in all the criteria for severity, extent, and ratio between AD and non-dementia cases and in the ratio between AD and VaD. Between AD and non-dementia, the sensitivity and specificity of severity were 100% and 45%, respectively, using the cutoff value of 1.19. When using the cutoff value of 14.2 for extent, the sensitivity and specificity were both 100%. Using the cutoff value of 2.22 for ratio, the sensitivity of 42% and specificity of 100% were demonstrated. When comparing AD with VaD, using the cutoff value of 2.22 for ratio, the sensitivity and specificity were 42% and 100%, respectively. Using the cutoff value of 1.5 for ratio, the sensitivity and specificity between AD and VaD were 92% and 80%, respectively, thereby showing the best results. CONCLUSIONS: The specific VOI analysis program of AD using specific voxel-based Z score maps is not influenced by interobserver differences among radiologists and is useful to discriminate AD from VaD and non-dementia. However, the setting of the cutoff value at each institution and comparison with original and eZIS images are suggested to distinguish better AD from VaD.

Evaluation of cerebral perfusion in patients with neuropsychiatric systemic lupus erythematosus using 123I-IMP SPECT.

OBJECTIVE: In the course of systemic lupus erythematosus (SLE), central nervous system (CNS) complications occur at a high frequency. An accurate diagnosis of CNS lupus, differentiated from secondary CNS involvement, is difficult. CNS lupus is indicative of advancing primary disease and is treated by steroid pulse therapy or increased dosage of steroids. In contrast, if symptoms are caused by secondary CNS complications, it is possible to observe or treat these complications using symptomatic therapy. We examined whether quantitative cerebral blood flow (CBF) measured using cerebral perfusion single photon emission computed tomography (SPECT) can be used to differentiate CNS lupus from secondary CNS involvement. METHODS: We divided 18 SLE patients with CNS symptoms into a CNS lupus group and a non-CNS lupus group, and then compared the mean cerebral blood flow (mCBF) of each group of patients. SPECT was performed with N-isopropyl-p-[123I] iodoamphetamine (IMP), with quantitation carried out by table look-up and autoradiographic methods. RESULTS: The mCBF of both groups was decreased; however, the mCBF of patients with CNS lupus was significantly lower than that of non-CNS lupus patients. CONCLUSION: Quantitative CBF may provide a useful tool to distinguish CNS lupus from non-CNS lupus.

Multiple and incidentally found cancers detected by 18F-FDG positron emission tomography/CT at one examination.

During the initial 8 months period of 18F-FDG PET/CT examination in our institution eleven cases of double cancers were detected. Eight cases were simultaneous second cancers and 3 cases are consecutive cancers. All cases are clinical ones and were referred from both outside hospitals and our own hospital. 18F-FDG PET/CT examination were utilized either to determine the extent of tumor or to stage the cancer or to detect recurrent tumors during the follow-up period. During the 8-months period 964 cases were studied. Therefore, the detection rates of simultaneous and consecutive cancers are 0.83% and 0.31% respectively. All together the detection rate of double cancer was 1.14%. To gain the general conception of double cancers the authors reviewed the autopsy registry of Japanese Society of Pathology during the four years from 2000 through 2003, and tabulated the combination of primary and second cancers. Frequently found combination of cancers were cancers of the thyroid, lung, stomach, liver, biliary tract, colon, rectum, and prostate. 18F-FDG PET/CT examination seems to be very useful in the management of cancer patients in terms of whole patient care.

Apparent diffusion coefficient on magnetic resonance imaging (MRI) in bladder cancer: relations with recurrence/progression risk.

AIMS: To evaluate the relationship between the apparent diffusion coefficient (ADC) value for bladder cancer and the recurrence/progression risk of post-transurethral resection (TUR). METHODS: Forty-one patients with initial and non-muscle-invasive bladder cancer underwent MRI from 2009 to 2012. Two radiologists measured ADC values. A pathologist calculated the recurrence/progression scores, and risk was classified based on the scores. Pearson's correlation was used to analyze the correlations of ADC value with each score and with each risk group, and the optimal cut-off value was established based on receiver operating characteristic (ROC) curve analysis. Furthermore, the relationship between actual recurrence / progression of cases and ADC values was examined by Unpaird U test. RESULTS: There were significant correlations between ADC value and the recurrence score as well as the progression score (P<0.01, P<0.01, respectively). There were also significant correlations between ADC value and the recurrence risk group as well as progression risk group (P=0.042, P<0.01, respectively). The ADC cut-off value on ROC analysis was 1.365 (sensitivity 100%; specificity 97.4%) for the low and intermediate recurrence risk groups, 1.024 (sensitivity 47.4%; specificity 100%) for the intermediate and high recurrence risk groups, 1.252 (sensitivity 83.3%; specificity 81.3%) for the low and intermediate progression risk groups, and 0.955 (sensitivity 87.5%; specificity 63.2%) between the intermediate and high progression risk groups. The difference between the ADC values of the recurrence and nonrecurrence group in Unpaired t test was significant (P<0.05). CONCLUSION: ADC on MRI in bladder cancer could potentially be useful, non-invasive measurement for estimating the risks of recurrence and progression.

Placental recess accompanied by a T2 dark band: a new finding for diagnosing placental invasion.

PURPOSE: Our aim was to assess the usefulness of a new magnetic resonance imaging (MRI) finding, the placental recess, for diagnosing placental invasion. METHODS: This retrospective study included 51 patients (mean age 34.1 years, range 26-43 years) with suspected placental invasion who underwent cesarean section. Preoperative MRI was performed using a 1.5-T unit and included axial, sagittal, and coronal T2-weighted imaging (T2WI) with half-Fourier fast spin-echo sequences. Overall, 9 patients showed placental invasion, and 42 did not. Placental recess was defined as a placental deformity with contraction of the placental surface and outer rim of the uterus accompanied by a T2 dark band. Two radiologists independently assessed the presence of the placental recess and conventional findings including uterine bulging, abnormal placental vascularity, placental heterogeneous intensity on T2-weighted imaging (T2WI), and the T2 dark band. Fisher's two-sided exact test was used to compare findings between patients with and without placental invasion. Interobserver reliability was assessed using the kappa statistic. RESULTS: MRI features had interobserver reliability of >0.40. Placental recess yielded the highest kappa value (0.898). Significant differences were identified between patients with and without placental invasion regarding abnormal placental vascularity, placental heterogeneous intensity, a T2 dark band, and the placental recess on T2WI (p = 0.0282, 0.0003, 0.0003, <0.0001, respectively). The placental recess had sensitivity, specificity, positive and negative predictive values, and accuracy of 56, 100, 100, 91, and 92%, respectively. CONCLUSION: The placental recess was useful for diagnosing placental invasion, with high interobserver variability and accuracy.

Comparison of integrated whole-body PET/MR and PET/CT: Is PET/MR alternative to PET/CT in routine clinical oncology?

PURPOSE: To compare the diagnostic accuracy of whole-body PET/CT and integrated PET/MR in relation to the total scan time durations. METHODS: One hundred and twenty-three (123) patients (40 males and 83 females; mean age 59.6 years; range 20-83 years) with confirmed primary cancer and clinical suspicion of metastatic disease underwent whole-body 18F-FDG-PET/CT and 18F-FDG-PET/MR. Data acquisition was done after intravenous administration of 110-301 MBq radioactivity of 18F-FDG, and PET/MR data were acquired after the PET/CT data acquisition. The mean uptake times for PET/CT and PET/MR acquisition were 68.0 ± 8.0 and 98.0 ± 14 min, respectively. Total scan time was 20.0 and 25.0 min for whole-body PET/CT and PET/MR imaging. RESULTS: The reconstructed PET/CT and PET/MR data detected 333/355 (93.8 %) common lesions in 111/123 (90.2 %) patients. PET/CT and PET/MR alone detected 348/355 and 340/355 lesions, respectively. No significant (p = 0.08) difference was observed for the overall detection efficiency between the two techniques. On the other hand, a significant difference was observed between the two techniques for the detection of lung (p = 0.003) and cerebrospinal (p = 0.007) lesions. The 15 lesions identified by PET/CT only included 8 lung, 3 lymph nodes, 2 bone, and 1 each of peritoneal and adrenal gland lesions. On the other hand, 7 (6 brain metastatic lesions and 1 bone lesion) were identified by PET/MR only. CONCLUSION: Integrated PET/MR is a feasible whole-body imaging modality and may score better than PET/CT for the detection of brain metastases. To further prove diagnostic utility, this technique requires further clinical validation.

Analysis of chromosome translocation frequency after a single CT scan in adults.

We recently reported an increase in dicentric chromosome (DIC) formation after a single computed tomography (CT) scan (5.78-60.27 mSv: mean 24.24 mSv) and we recommended analysis of 2000 metaphase cells stained with Giemsa and centromere-FISH for dicentric chromosome assay (DCA) in cases of low-dose radiation exposure. In the present study, we analyzed the frequency of chromosome translocations using stored Carnoy's-fixed lymphocyte specimens from the previous study; these specimens were from 12 patients who were subject to chromosome painting of Chromosomes 1, 2 and 4. Chromosomes 1, 2 and 4 were analyzed in ∼5000 cells, which is equivalent to the whole-genome analysis of almost 2000 cells. The frequency of chromosome translocation was higher than the number of DICs formed, both before and after CT scanning. The frequency of chromosome translocations tended to be higher, but not significantly higher, in patients with a treatment history compared with patients without such a history. However, in contrast to the results for DIC formation, the frequency of translocations detected before and after the CT scan did not differ significantly. Therefore, analysis of chromosome translocation may not be a suitable assay for detecting chromosome aberrations in cases of low-dose radiation exposure from a CT scan. A significant increase in the frequency of chromosome translocations was not likely to be detected due to the high baseline before the CT scan; the high and variable frequency of translocations was probably due to multiple confounding factors in adults.

3D-CT arteriography and 3D-CT venography: the separate demonstration of arterial-phase and venous-phase on 3D-CT angiography in a single procedure.

Although 3D-CT angiography provides valuable anatomic information regarding lesion and their surrounding vessels and bony structures, it cannot demonstrate lesions, arteries, and veins, separately. The separate demonstration of arterial-phase 3D-CT angiography (3D-CT arteriography) and venous-phase 3D-CT angiography (3D-CT venography) will facilitate the understanding of the vascular anatomy within lesions, thus, allowing improvement of diagnostic accuracy and potentially a safer surgical approach. We describe 3D-CT arteriography and 3D-CT venography by using a multidetector row helical CT.

Impact of sentinel node navigation technique for carcinoma of tongue with cervical node metastases.

We attempted lymph node mapping for clinically positive neck using sentinel node navigation technique. Technetium labeled rhenium sulfide was injected as a radiotracer in 11 patients with squamous cell carcinoma of the tongue. After surgery, the radioactivity and the ratio of metastatic area (RMA) of the removed nodes were measured. Average RMA (57%) of 18 high radioactive metastatic nodes was significantly lower than the RMA (90%) of 16 low radioactive metastatic nodes. Average number of metastatic nodes (4.7 nodes) in the five cases with low radioactive metastatic nodes was significantly larger than that (1.8 nodes) in the six cases with only high radioactive metastatic nodes. There is no accumulation of radioactive tracer if a lymph node is totally or predominantly occupied by metastatic cells. When the sentinel node was mostly occupied by malignant cells, the injected colloid could not flow to the sentinel node and flowed to a different lymph node through another basin. Sentinel node navigation technique can show the actual time of lymphatic flow at the operation of positive neck cases.

VALIDATION OF THERAPEUTIC RESPONSE ASSESSMENT BY BONE SCINTIGRAPHY IN PATIENTS WITH BONE-ONLY METASTATIC BREAST CANCERS DURING ZOLEDRONIC ACID TREATMENT: COMPARISON WITH COMPUTED TOMOGRAPHY ASSESSMENT.

PURPOSE: To validate the use of bone scintigraphy (BS) versus computed tomography (CT) for therapeutic monitoring in patients during treatment with zoledronic acid. MATERIALS AND METHODS: Eleven patients with bone-only metastatic disease and being treated with zoledronic acid were included. The effects of therapies including chemotherapy and hormone therapy were evaluated in 25 separate examinations in total as follows: complete response (CR), when no bone metastasis was visible; partial response (PR), when a decrease in the lesion area was detected; stable disease (SD), when no or slight change was observed; and progressive disease (PD), when new or enlarged lesion areas were observed. RESULTS: The accuracies of examination by Readers 1, 2, and 3 respectively were 76%, 80% and 76% for BS, 52%, 48%, and 40% for CT, and 64%, 52% and 60% for BS and CT combined with Readers 2 and 3 observing significant differences between CT and BS results. The rates of interobserver agreement between Readers 1 and 2, between Readers 1 and 3, and between Reader 2 and 3 respectively, were 84%, 80% and 88% (κ = 0.648, 0.561 and 0.766) for BS, 52%, 56%, and 60% (κ = 0.180, 0.278 and 0.282) for CT, and 52%, 60%, and 56% (κ = 0.215, 0.282 and 0.232) for CT and BS combined. CONCLUSION: BS is effective for assessing the response of bone metastasis to therapy in patients during zoledronic acid treatment.

Factors Contributing to Early Recovery of Urinary Continence Analyzed by Pre- and Postoperative Pelvic Anatomical Features at Robot-Assisted Laparoscopic Radical Prostatectomy.

OBJECTIVE: The aim of the present study is to elucidate factors contributing to early recovery of urinary continence after robot-assisted laparoscopic radical prostatectomy (RARP) from the perspective of urethral and vesical anatomical features after RARP. PATIENTS AND METHODS: Sixty consecutive patients undergoing RARP also underwent pre- and postoperative urethrovesicography (UVG). Both pre- and postoperative UVG evaluated the posterior-urethral vesical angle and position of the urethrovesical junction. Postoperative UVG was performed 7 days after RARP and also evaluated postoperative membranous urethral length (MUL) and the postoperative degree of atony of the external urethral sphincter. Associations were analyzed between pre- or postoperative UVG variables and urinary incontinence as well as between UVG variables significantly correlating with urinary incontinence and neurovascular bundle-preservation procedures. RESULTS: Postoperative MUL was the only factor significantly associated with the state of continence in the early postoperative period according to multivariate logistic regression analysis (odds ratio, 1.94; 95% confidence interval, 1.22-3.12; p<0.005). A cutoff value of 17 mm offered the best accuracy in receiver operating characteristics analysis. Postoperative MUL was significantly increased in the group with preservation of the neurovascular bundle (p=0.01). CONCLUSIONS: Postoperative MUL is the most important factor for recovery of urinary continence in the early postoperative period after RARP. Postoperative MUL >17 mm as measured on UVG can be expected to predict early recovery of urinary continence. Postoperative MUL was greater with preservation of the neurovascular bundle, thus allowing early recovery of urinary continence.

Changes in radiological imaging frequencies in children before and after the accident at the Fukushima Daiichi Nuclear Power Plant in Fukushima Prefecture, Japan.

PURPOSE: The accident at the Fukushima Daiichi Nuclear Power Plant has raised concerns about radiation exposure, including medical radiation exposure such as X-ray and CT, in residents of Fukushima. MATERIALS AND METHODS: We compared the numbers and the ratio of outpatients less than 10 years old who underwent imaging examinations [e.g., CT, X-ray, MRI, ultrasonography (US), etc.] at Fukushima Medical University hospital in Fukushima, Japan before (April 1, 2008-March 31, 2011) and after (April 1, 2011-March 31, 2014) the accident. RESULTS: The number of outpatients less than 10 years old decreased after the accident. The number of outpatients less than 10 years old who underwent CT and X-ray examinations also significantly decreased after the accident (p < 0.001, p < 0.01, respectively). CONCLUSION: Our results suggest that the number of pediatric radiological examinations decreased after the accident in Fukushima. We should continue to communicate with patients and their families to ensure that they understand the risks and benefits of radiological imaging in order to overcome their concerns about the nuclear disaster.

Increase in dicentric chromosome formation after a single CT scan in adults.

Excess risk of leukemia and brain tumors after CT scans in children has been reported. We performed dicentric chromosome assay (DCAs) before and after CT scan to assess effects of low-dose ionizing radiation on chromosomes. Peripheral blood (PB) lymphocytes were collected from 10 patients before and after a CT scan. DCA was performed by analyzing either 1,000 or 2,000 metaphases using both Giemsa staining and centromere-fluorescence in situ hybridization (Centromere-FISH). The increment of DIC formation was compared with effective radiation dose calculated using the computational dosimetry system, WAZA-ARI and dose length product (DLP) in a CT scan. Dicentric chromosome (DIC) formation increased significantly after a single CT scan, and increased DIC formation was found in all patients. A good correlation between the increment of DIC formation determined by analysis of 2,000 metaphases using Giemsa staining and those by 2,000 metaphases using Centromere-FISH was observed. However, no correlation was observed between the increment of DIC formation and the effective radiation dose. Therefore, these results suggest that chromosome cleavage may be induced by one CT scan, and we recommend 2,000 or more metaphases be analyzed in Giemsa staining or Centromere-FISH for DCAs in cases of low-dose radiation exposure.

Acute aneurysm surgery using three-dimensional CT angiogrphy without conventional catheter angiography.

The object of this study is to assess whether aneurysm surgery can be performed in patients with ruptured cerebral aneurysms by using three-dimensional computerized tomography angiography (3D-CTA) alone, without conventional catheter angiography (CCA). Between May 1994 and November 1996, a consecutive series of 60 cases of ruptured cerebral aneurysms was evaluated by both 3D-CTA and CCA prospectively and compared the detectability of cerebral aneurysms. Both 3D-CTA and CCA demonstrated a 100% diagnostic accuracy of ruptured cerebral aneurysms. In the associated unruptured cerebral aneurysms, the diagnostic accuracies of 3D-CTA and CCA were 96% and 92%, respectively. Based on the results, we have operated on 128 consecutive patients with ruptured aneurysms in the acute stage based on 3D-CTA findings since December 1996. One hundred twenty eight ruptured aneurysms including 50 associated unruptured aneurysms were detected by 3D-CTA. In seven of 128 ruptured aneurysms, which included four dissecting vertebral artery aneurysms, two basilar artery (BA) tip aneurysms, and one BA-superior cerebellar artery (SCA) aneurysm, 3D-CTA was followed by CCA to obtain diagnostic confirmation or information concerning the vein of Labbé, which was needed to guide the surgical approach for BA tip aneurysms. All of the ruptured aneurysms were confirmed at surgery and treated successfully. One hundred twenty one patients who underwent surgery with 3D-CTA findings only had no complications related to the lack of information of CCA. The authors considered that 3D-CTA could replace CCA in the diagnosis of ruptured aneurysms and that surgery could be performed in almost all acutely ruptured aneurysms by using only 3D-CTA without CCA.

A phase II study of radiofrequency ablation therapy for thoracic malignancies with evaluation by FDG-PET.

PURPOSE: Computed tomography (CT)-guided radiofrequency ablation (RFA) is safe and effective for patients with unresectable primary, recurrent, or metastatic thoracic malignancies. Several studies have shown the benefit of employing 18-fluoro-deoxyglucose positron-emission tomography (FDG-PET) to follow thoracic malignancies treated with RFA. In this prospective study, we show the safety and therapeutic efficacy of RFA and the utility of FDG-PET as tool for early detection of local recurrence. METHODS: Twenty patients were enrolled in this study, and 24 lesions were ablated. Seven lesions were primary lung cancer, and 17 lesions were recurrent tumors or metastases from extrathoracic sites. Tumor size was in the range of 0.4-3.3 cm in diameter (mean: 1.5 cm). CT and FDG-PET scans were scheduled 7-14 days and 3-6 months after RFA treatment. RESULTS: There were 17 adverse events (70.8 %) in 24 ablations included 13 pneumothoraces, two cases of chest pain, and two episodes of fever. With a median follow-up of 35.9 months (range 1-62 months), the overall 2-year survival rate was 84.2 %. Local recurrence occurred at four sites (2-year local control rate was 74.3 %). The FDG-PET results 7-14 days after RFA did not predict recurrence, whereas positive findings 3-6 months after RFA significantly correlated with local recurrence (p = 0.0016). CONCLUSIONS: We confirmed the effectiveness of RFA for unresectable primary and secondary thoracic malignancies. FDG-PET analysis 3-6 months after ablation is a useful tool to assess local control.

A strategy for a rapid radiological screening survey in large scale radiation accidents: a lesson from an individual survey after the Fukushima Daiichi nuclear power plant accidents.

To establish a strategy for a rapid screening survey of surface contamination among a large number of people after nuclear power plant (NPP) accidents, the authors analyzed the measured surface contamination of subjects. From 12 March through 25 March 2011, a screening survey was conducted in a hospital on 336 subjects who had stayed within a 50-km radius of the Fukushima Daiichi NPPs. The count rates from measuring points of each subject were measured and compared in association with individual characteristics such as survey timing, gender, age, and distance between their location and the Fukushima Daiichi NPPs. The count rates from the head, hands, and clothes of subjects were correlated to the survey timing and distance by multiple regression analyses. When subjects were divided into two-by-two groups of survey timing and distance, the count rates from hands were not significantly different from those of the head and clothes. However, the count rates from the shoes of the subjects, excluding one group, were significantly higher than those of the other points. In addition, the count rate from a married couple showed a significant correlation. These findings suggest that measurement of at least two regions, such as one hand and one shoe, can be used as representative survey data in order to save surveillance time for a large number of people.