kiʻi lāʻau lapaʻau
Ua ʻike ʻo Wilhelm Roentgen i nā kukui X i ka makahiki 1896, a i ka makahiki 1900 ka pahu X-ray mua. A laila ʻike ʻia ka paipu X-ray. A pehea ke ʻano o kēia lā. E ʻike ʻoe ma ka ʻatikala ma lalo nei.
1806 Hoʻokumu ʻo Philippe Bozzini i ka endoscope ma Mainz, e paʻi ana i ka manawa "Der Lichtleiter", kahi puke e pili ana i ke aʻo ʻana i nā recesses o ke kino kanaka. ʻO ka mea mua i hoʻohana i kēia hāmeʻa i kahi hana kūleʻa ʻo ka Farani Antonin Jean Desormeaux. Ma mua o ka hana ʻia ʻana o ka uila, ua hoʻohana ʻia nā kumu kukui waho e nānā i ka ʻōpū, ka ʻōpū a me ke kolonā, a me nā lua ihu.
1. ʻO ka x-ray mua - ka lima o ka wahine a Roentgen
1896 ʻIke ʻo Wilhelm Roentgen i nā kukui X a me ko lākou hiki ke komo i nā mea paʻa. ʻO nā mea lapaʻau mua loa āna i hōʻike ai i kāna "roentgenograms" ʻaʻole nā kauka, akā ʻo nā hoa hana o Roentgen - physicists (1). Ua ʻike ʻia ka hiki ke hoʻomaʻamaʻa o kēia mea hou i kekahi mau pule ma hope mai i ka wā i paʻi ʻia ai kahi x-ray o kahi ʻāpana aniani ma ka manamana lima o kahi keiki ʻehā makahiki i loko o kahi puke pai lāʻau. I nā makahiki e hiki mai ana, hoʻolaha ka hoʻolaha ʻana a me ka hana nui o nā paipu X-ray i ka ʻenehana hou a puni ka honua.
1900 X-ray umauma mua. ʻO ka hoʻohana nui ʻana i ka lekiō umauma i hiki ai ke ʻike i ka maʻi maʻi i ka wā mua, ʻo ia kekahi o nā kumu maʻamau o ka make i kēlā manawa.
1906-1912 ʻO ka hoʻāʻo mua e hoʻohana i nā mea ʻokoʻa no ka nānā maikaʻi ʻana i nā kino a me nā kīʻaha koko.
1913 Ke puka mai nei kekahi paipu X-ray maoli i kapa ʻia ʻo ka hot cathode vacuum tube, e hoʻohana ana i ke kumu hoʻomalu pono o nā electrons ma o ke ʻano o ka thermionic emission. Ua hoʻomaka ʻo ia i kahi au hou i ka hana radiology lapaʻau a me ka ʻenehana. ʻO William D. Coolidge (2) ka mea nāna i hana, ʻo ia ka "makuakāne o ka paipu X-ray." Me kahi mākia hoʻoneʻe i hana ʻia e Chicago radiologist ʻo Hollis Potter, ua hana ke kukui Coolidge i ka radiography i mea waiwai nui no nā kauka i ke Kaua Honua I.
1916 ʻAʻole maʻalahi ka heluhelu ʻana i nā hihi-x a pau—i kekahi manawa ua uhi ʻia nā kiko a i ʻole nā mea i ka mea e nānā ʻia nei. No laila, ua hoʻomohala ʻo Andre Bocage, ka mea dermatologist Farani i ke ʻano o ka hoʻokuʻu ʻana i nā kukui X ma nā kihi like ʻole, kahi i hoʻopau ai i kēlā mau pilikia. ʻO kāna .
1919 Hōʻike ʻia ka pneumoencephalography, kahi kaʻina diagnostic invasive o ka ʻōnaehana nerve waena. ʻO ia ka hoʻololi ʻana i kahi ʻāpana o ka wai cerebrospinal me ka ea, ka oxygen a i ʻole ka helium, i hoʻokomo ʻia ma o kahi puncture i loko o ke kuamoʻo, a lawe i kahi X-ray o ke poʻo. Ua ʻokoʻa maikaʻi nā kinoea me ka ʻōnaehana ventricular o ka lolo, i hiki ai ke loaʻa nā kiʻi o nā ventricular. Ua hoʻohana nui ʻia ke ʻano i ka waena o ke kenekulia iwakālua, akā ua aneane haʻalele loa ʻia i ka 80s, no ka mea, ua ʻeha loa ka hoʻokolokolo ʻana i ka mea maʻi a lawe i kahi pilikia nui o nā pilikia.
30s a me 40s Ke hoʻomaka nei ka ikaika o nā hawewe kani ultrasonic e hoʻohana nui ʻia i ka lāʻau lapaʻau kino a me ka hoʻoponopono hou ʻana. Ke hoʻāʻo nei ʻo Russian Sergei Sokolov me ka hoʻohana ʻana i ka ultrasound e ʻike i nā hemahema metala. I ka makahiki 1939, hoʻohana ia i ka alapine o 3 GHz, ʻaʻole naʻe e hāʻawi i ka hoʻonā kiʻi ʻoluʻolu. I ka makahiki 1940, ua hōʻike ʻo Heinrich Gore lāua ʻo Thomas Wedekind o ke Kulanui Lapaʻau o Cologne, Kelemānia, i kā lāua pepa "Der Ultraschall in der Medizin" i ka hiki ke hana i nā diagnostics ultrasound e pili ana i nā ʻenehana echo-reflex e like me nā mea i hoʻohana ʻia i ka ʻike ʻana i nā hemahema o nā metala. .
Ua manaʻo nā mea kākau e hiki i kēia ala ke ʻike i nā ʻōpū, exudates, a i ʻole abscesses. Akā naʻe, ʻaʻole hiki iā lākou ke hoʻopuka i nā hopena hōʻoiaʻiʻo o kā lākou hoʻokolohua. ʻIke pū ʻia nā hoʻokolohua lapaʻau ultrasound o ka Austrian Karl T. Dussick, he neurologist ma ke Kulanui o Vienna ma Austria, i hoʻomaka i ka hopena o 30s.
1937 Hoʻokumu ka mea makemakika Polani ʻo Stefan Kaczmarz i kāna hana "Algebraic Reconstruction Technique" i nā kumu kumu o ke ʻano hana hou algebraic, a laila hoʻohana ʻia i ka tomography computed a me ka hana hōʻailona kikohoʻe.
40s. ʻO ka hoʻokomo ʻana i kahi kiʻi tomographic me ka hoʻohana ʻana i kahi paipu X-ray i hoʻohuli ʻia a puni ke kino o ka mea maʻi a i ʻole nā mea kino. Ua ʻae kēia iā mākou e ʻike i nā kikoʻī anatomical a me nā loli pathological i nā ʻāpana.
1946 Ua hoʻokumu kūʻokoʻa ʻo Edward Purcell lāua ʻo Felix Bloch i nā physicists ʻAmelika i ka nuclear magnetic resonance NMR (3). Ua loaʻa iā lākou ka makana no ka Nobel no Physics no "ka hoʻomohala ʻana i nā ʻano hou o ke ana pololei a me nā ʻike pili i ke kahua o ka nuklea magnetism."
3. NMR lako lako
1950 kū aʻe ʻimi laina pololei, i houluuluia e Benedict Cassin. Ua hoʻohana ʻia kēia ʻano o ka hāmeʻa a hiki i ka makahiki 70 me nā lāʻau lapaʻau radioactive isotope e pili ana i nā kino kiʻi a puni ke kino.
1953 Hoʻokumu ʻo Gordon Brownell o ka Massachusetts Institute of Technology i kahi mea hana i mua o ka kāmela PET hou. Me kāna kōkua, hoʻokele ʻo ia a me ka neurosurgeon William H. Sweet i ka hoʻomaʻamaʻa ʻana i ka lolo lolo.
1955 Ke hoʻomohala ʻia nei nā mea hoʻoikaika kiʻi X-ray e hana i nā kiʻi X-ray o nā kiʻi neʻe o nā ʻiʻo a me nā kino. Hāʻawi kēia mau kukui X i ka ʻike hou e pili ana i nā hana o ke kino e like me ke kuʻi ʻana o ka naʻau a me ka ʻōnaehana moku koko.
1955-1958 Hoʻomaka ke kauka Scottish ʻo Ian Donald e hoʻohana nui i nā hoʻokolohua ultrasound no nā diagnostics olakino. Hana ʻo ia i ka gynecology. ʻO kāna ʻatikala, "Investigation of Abdominal Masses by Pulsed Ultrasound," i paʻi ʻia ma Iune 7, 1958, ma ka puke moʻolelo olakino ʻo Lancet, wehewehe i ka hoʻohana ʻana i ka ʻenehana ultrasound a kau i ke kumu no ka maʻi prenatal (4).
1957 Ua hoʻomohala ʻia ka endoscope fiber-optic mua - ʻo ka gastroenterologist ʻo Basili Hirschowitz a me kāna mau hoa hana mai ke Kulanui o Michigan e patent i kahi fiber-optic, gastroscope semi-flexible.
1958 Hāʻawi ʻo Hal Oscar Anger i ka hālāwai makahiki o ka American Society of Nuclear Medicine i kahi keʻena scintillation e hiki ai i ka ikaika. ʻike ʻana i nā kino kanaka. Hoʻokomo ka mīkini i ka mākeke i hoʻokahi makahiki ma hope.
1963 ʻO ke kauka hou ʻo David Kuhl, a me kāna hoa, ʻenekinia ʻo Roy Edwards, ke hōʻike nei i ka honua i kā lākou hana hui mua, ka hopena o nā makahiki he nui o ka hoʻomākaukau: ʻo ka mea hana mua o ka honua no ka mea i kapa ʻia. ka hoʻokuʻu ʻanaa kapa aku lakou i ka inoa o Mareko II. I nā makahiki e hiki mai ana, ua hoʻomohala ʻia nā kumumanaʻo kūpono a me nā hiʻohiʻona makemakika, ua hana ʻia nā haʻawina he nui a ua kūkulu ʻia nā mīkini ʻoi aku ka maikaʻi. ʻO ka hope, i ka makahiki 1976, ua hana ʻo John Keyes i ka mīkini SPECT mua - hoʻokahi photon emission tomography - e pili ana i ka ʻike o Coole lāua ʻo Edwards.
1967-1971 Ke hoʻohana nei i ke ʻano algebraic a Stefan Kaczmarz, ua haku ʻia ka ʻenekini uila Pelekane ʻo Godfrey Hounsfield i nā kumu kumu o ka helu helu helu. I nā makahiki i hala aʻe, ua kūkulu ʻo ia i ka CT scanner hana mua, ʻo EMI (5), nāna i hana i ka hoʻokolokolo kanaka mua ma 1971 ma Atkinson Morley Hospital ma Wimbledon. Ua hele ka mea hana i ka makahiki 1973. I ka makahiki 1979, ua hāʻawi ʻia ʻo Hounsfield, a me ka physicist ʻAmelika ʻo Allan M. Cormack, i ka makana Nobel no kā lākou hāʻawi ʻana i ka hoʻomohala ʻana i ka tomography computed.
5. Electromagnetic Interference Scanner
1973 Ua ʻike ʻo Paul Lauterbur (6) ka mea hoʻomaʻamaʻa ʻAmelika ma ka hoʻokomo ʻana i nā gradients o kahi māla magnetic e hele ana i kahi mea i hāʻawi ʻia, hiki ke nānā a hoʻoholo i ke ʻano o kēia mea. Hoʻohana ka ʻepekema i kēia ʻenehana e hana i kahi kiʻi e hoʻokaʻawale i waena o ka wai maʻamau a me ka wai kaumaha. Ma muli o kāna hana, kūkulu ʻo Peter Mansfield physicist Pelekane i kāna manaʻo ponoʻī a hōʻike i ke kiʻi wikiwiki a pololei i ke ʻano o loko.
ʻO ka hopena o ka hana a nā ʻepekema ʻelua he hoʻokolohua lapaʻau non-invasive i kapa ʻia ʻo magnetic resonance imaging, a i ʻole MRI. I ka makahiki 1977, ua hoʻohana ʻia ka mīkini MRI, i hoʻomohala ʻia e nā kauka ʻAmelika ʻo Raymond Damadian, Larry Minkoff a me Michael Goldsmith, no ka manawa mua e aʻo ai i kahi kanaka. Ua loaʻa pū ʻia ʻo Lauterbur lāua ʻo Mansfield i ka 2003 Nobel Prize in Physiology or Medicine.
1974 Ke hoʻomohala nei ʻo ʻAmelika Michael Phelps i kahi kāmela no ka positron emission tomography (PET). Ua hoʻokumu ʻia ka mea scan PET pāʻoihana mua ma muli o ka hana a Phelps a me Michel Ter-Poghossian, nāna i alakaʻi i ka hana ʻana o ka ʻōnaehana e EG&G ORTEC. Ua hoʻokomo ʻia ka scanner ma UCLA i ka makahiki 1974. No ka mea, ʻoi aku ka wikiwiki o ka hoʻoheheʻe ʻana o nā maʻi maʻi i ka glucose i ʻumi mau manawa ma mua o nā cell maʻamau, ʻike ʻia nā maʻi maʻi maʻi ma ke ʻano he mau kikoʻī ma ka PET scans (7).
1976 Hāʻawi ʻo Surgeon Andreas Grünzig i ka coronary angioplasty ma ka Halemai University Zurich, Switzerland. Hoʻohana kēia ʻano i ka fluoroscopy e mālama i ka stenosis o nā kīʻaha koko.
1978 kū aʻe lekiō kikohoʻe. No ka manawa mua, ua hoʻololi ʻia kahi kiʻi mai kahi ʻōnaehana X-ray i faila kikohoʻe, a laila hiki ke hana ʻia no ka ʻike maʻalahi a mālama ʻia i nā kikohoʻe no ka noiʻi a me ka nānā ʻana.
80s. Hoʻokomo ʻo Douglas Boyd i ka ʻenehana electron beam tomography. Ua hoʻohana ʻo ia mau mea ʻimi scan tomography (EBT) i kahi kukuna electrons i hoʻokele ʻia e hana i ke apo o nā kukui X.
1984 Hoʻokomo ʻia ka hoʻoili kiʻi 3D mua me ka hoʻohana ʻana i nā kamepiula kikohoʻe a me ka ʻikepili CT a i ʻole MRI e hana i nā kiʻi XNUMXD o nā iwi a me nā ʻāpana.
1989 Ke hoʻohana ʻia nei ka tomography i hoʻohālikelike ʻia (spiral CT). He ho'āʻo kēia i hui pū ʻia me ka neʻe ʻana o ka neʻe ʻana o ka ʻōnaehana ʻike kukui a me ka neʻe ʻana o kahi papa ma luna o ka ʻili hoʻāʻo (8). ʻO kahi pōmaikaʻi koʻikoʻi o ka spiral tomography ʻo ka hōʻemi ʻana i ka manawa hoʻokolokolo (e ʻae iā ʻoe e kiʻi i nā kiʻi o nā papa he nui i ka scan hoʻokahi mau kekona), ka hōʻiliʻili ʻana o nā heluhelu mai ka leo holoʻokoʻa, me nā ʻāpana okana, aia ma waena o nā scan me CT kuʻuna, a me ka hoʻololi scan maikaʻi loa no ka polokalamu hou. ʻO ka luna hoʻokele o ka hana hou ʻo Siemens Research and Development Director ʻo Kauka Willi A. Kalender. Ma hope koke iho, ua hahai nā mea hana ʻē aʻe i nā wāwae o Siemens.
8. Papahana o ka spiral computed tomography
1993 No ka hoʻomohala ʻana i kahi ʻenehana echoplanar imaging (EPI) e hiki ai i nā ʻōnaehana MRI ke ʻike i ka hahau ʻino i ka wā mua. Hāʻawi pū ka EPI i ke kiʻi hana, e like me ka hana o ka lolo, e ʻae i nā kauka e aʻo i ka hana o nā ʻāpana like ʻole o ka lolo.
1998 ʻO nā haʻawina PET multimodal i kapa ʻia me ka tomography computed. Ua hana ʻia kēia e Kauka David W. Townsend o ke Kulanui o Pittsburgh me Ron Nutt, he loea i nā ʻōnaehana PET. Ua wehe kēia i nā manawa nui no ka metabolic a me ka anatomical imaging o nā maʻi maʻi maʻi. ʻO ka prototype PET/CT scanner mua, i hoʻolālā ʻia a kūkulu ʻia e CTI PET Systems ma Knoxville, Tennessee, i hoʻomaka i ka hana ma 1998.
2018 Hāʻawi ʻo MARS Bioimaging i ka ʻenehana kala Kiʻi lāʻau 3D (9), ma kahi o nā kiʻi ʻeleʻele a keʻokeʻo o loko o ke kino e hāʻawi i kahi ʻano hou loa i ka lāʻau lapaʻau - nā kiʻi kala.
Ke hoʻohana nei ke ʻano scanner hou i ka ʻenehana Medipix, i hoʻomohala mua ʻia no nā ʻepekema ma ka European Organization for Nuclear Research (CERN) e nānā i nā ʻāpana ma ka Large Hadron Collider me ka hoʻohana ʻana i nā algorithms computer. Ma mua o ka hoʻopaʻa ʻana i nā hihi X i ko lākou hele ʻana i loko o ka ʻiʻo a me ke ʻano o ke komo ʻana, ʻike ka scanner i ke kiʻekiʻe o ka ikehu pololei o nā kukui X i ko lākou pā ʻana i nā ʻāpana like ʻole o ke kino. A laila hoʻololi i nā hopena i nā kala like ʻole e pili ana i nā iwi, nā ʻiʻo a me nā ʻiʻo ʻē aʻe.
9. ʻO ka ʻāpana kala o ka lima, i hana ʻia me ka ʻenehana MARS Bioimaging.
Ka hoʻokaʻawale ʻana o ke kiʻi lāʻau
1. Roentgen (x-ray) He x-ray kēia o ke kino ma ka hoʻolālā ʻana i nā kukui-x ma luna o kahi kiʻiʻoniʻoni a mea ʻike paha. ʻIke ʻia nā ʻiʻo palupalu ma hope o ka lawelawe ʻana i ka hoʻohālikelike. ʻO ke ʻano, i hoʻohana nui ʻia i ka ʻike ʻana i ka ʻōnaehana skeletal, ʻike ʻia e ka haʻahaʻa haʻahaʻa a me ka haʻahaʻa haʻahaʻa. Eia kekahi, he hopena maikaʻi ʻole ka radiation - 99% o ka maʻi i hoʻopili ʻia e ka mea hoʻāʻo.
2. kākalakala (Greek - cross section) - ka inoa hui o nā ʻano diagnostic e pili ana i ka loaʻa ʻana o kahi kiʻi o kahi ʻāpana keʻa o ke kino a i ʻole kekahi hapa o ia mea. Hoʻokaʻawale ʻia nā ʻano Tomographic i nā hui:
- Ultrasound - he ʻano hana ʻino ʻole e hoʻohana ana i nā ʻano nalu o ke kani ma nā palena o nā ʻano media like ʻole. Hoʻohana ia i ka ultrasonic (2-5 MHz) a me nā transducers piezoelectric. Ke neʻe nei ke kiʻi i ka manawa maoli;
- helu helu helu (CT) - hoʻohana i nā x-ray i hoʻokele ʻia e ka lolouila e hana i nā kiʻi o ke kino. ʻO ka hoʻohanaʻana i nā kukui X e hoʻokokoke aku iā CT i nā kukui X, akā hāʻawi nā X-ray a me nā CT scans i nāʻike likeʻole. He ʻoiaʻiʻo, hiki i ka mea radiologist akamai ke hoʻomaopopo i ka wahi ʻekolu-dimension o, no ka laʻana, he tumora mai kahi kiʻi x-ray, akā ʻo nā kukui-x, ʻaʻole like me ka CT scans, he mau ʻano ʻelua;
- ke kiʻi hoʻopaneʻe magnetic (MRI) - Ke hoʻohana nei kēia ʻano tomography i nā hawewe lekiō e nānā i nā maʻi i hoʻokomo ʻia i loko o kahi kahua magnetic ikaika. Hoʻokumu ʻia ke kiʻi ma luna o nā nalu lekiō i hoʻokuʻu ʻia e nā ʻiʻo e nānā ʻia, e hoʻohua ana i nā hōʻailona ʻoi aʻe a liʻiliʻi paha ma muli o ke ʻano kemika. Hiki ke mālama ʻia ke kiʻi kino o ka mea maʻi ma ke ʻano he ʻikepili kamepiula. ʻO MRI, e like me CT, hāʻawi i nā kiʻi XNUMXD a me XNUMXD, akā i kekahi manawa he ala ʻoi aku ka maʻalahi, ʻoi loa no ka ʻike ʻana i nā ʻiʻo palupalu;
- positron emission tomography (PET) - ke kākau inoa ʻana i nā kiʻi kamepiula o nā loli i ka metabolism kōpaʻa e kū nei i loko o nā kiko. Hāʻawi ʻia ka mea maʻi i kahi injection o kahi mea i hui pū ʻia me ke kō a me ka isotope-labeled sugar. Hiki i ka mea hope ke ʻimi i ka maʻi maʻi maʻi no ka mea ʻoi aku ka maikaʻi o ka hoʻomoʻa ʻana o nā molekole kō ma mua o nā ʻiʻo kino ʻē aʻe. Ma hope o ka lawe ʻana i ke kō radiolabeled, moe ka mea maʻi ma kahi kokoke.
- 60 mau minuke ʻoiai ke kaʻapuni ʻana o ke kō i loko o kona kino. Inā he maʻi koko i loko o ke kino, pono e hōʻiliʻili maikaʻi ke kō i loko. A laila, hoʻokomo ʻia ka mea maʻi ma ka papaʻaina i loko o ka PET scanner - 6-7 mau manawa ma luna o 45-60 mau minuke. Hoʻohana ʻia kahi scanner PET e hoʻoholo i ka hāʻawi ʻana o ke kō i loko o nā ʻiʻo kino. Mahalo i ka nānā ʻana o CT a me PET scans, hiki ke wehewehe maikaʻi ʻia kahi maʻi maʻi. ʻIke ʻia ke kiʻi i hana ʻia e ka lolouila. Hiki i ka PET ke ʻike i nā mea ʻino inā paha e hōʻike ana nā ala ʻē aʻe i ke kino maʻamau. Hiki iā ia ke ʻike i ka hoʻi hou ʻana o ka maʻi maʻi a hoʻoholo i ka maikaʻi o ka mālama ʻana - e like me ka emi ʻana o ke koko, ʻoi aku ka liʻiliʻi o ke kō;
- Hoʻokahi kiʻi paʻi kiʻi kiʻi kiʻi kiʻi (SPECT) - ʻenehana tomographic i ke kahua o ka lāʻau nuklea. Ke hoʻohana nei i ka radiation gamma, hiki ke hana i kahi kiʻi spatial o ka hana biological o kekahi ʻāpana o ke kino o ka mea maʻi. ʻO kēia ala e hiki ai iā ʻoe ke nānā i ke kahe koko a me ka metabolism ma kahi wahi i hāʻawi ʻia. Hoʻohana ia i nā radiopharmaceuticals. ʻO ia nā pūhui kemika i loaʻa i ʻelua mau mea - he tracer, he isotope radioactive, a he mea lawe i hiki ke waiho ʻia i loko o nā ʻiʻo a me nā kino a lanakila i ka pale koko-lolo. Loaʻa i nā mea lawe ka waiwai o ka hoʻopaʻa paʻa ʻana i nā antibodies o nā cell tumor. Noho lākou i nā nui e like me ka metabolism;
- ʻO ka hoʻopaʻa ʻana o ka optical coherence tomography (OCT) - he ala hou e like me ka ultrasound, akā e ʻimi ʻia ka mea maʻi me ka hoʻohana ʻana i ke kukui kukui (interferometer). Hoʻohana ʻia no ka nānā ʻana i ka maka ma ka dermatology a me ka dentistry. Hōʻike ke kukui backscattered iā mākou i ke kūlana o nā wahi ma ke ala o ka kukuna kukui kahi e hoʻololi ai ka index refractive.
3. ʻO Scintigraphy - ma aneʻi e loaʻa iā mākou kahi kiʻi o nā kino, a ma luna o kā lākou hana a pau, me ka hoʻohana ʻana i nā mea liʻiliʻi o nā isotopes radioactive (radiopharmaceuticals). Hoʻokumu ʻia kēia ʻenehana i ka hana o kekahi mau lāʻau lapaʻau i loko o ke kino. Hana lākou ma ke ʻano he kaʻa kaʻa no ka isotope i hoʻohana ʻia. ʻO ka lāʻau i hoʻopaʻa inoa ʻia e hōʻiliʻili i loko o ke kino e aʻo ʻia. Hoʻopuka ka radioisotope i ka radiation ionizing (ʻoi aku ka pinepine o ka radiation gamma), e komo ana ma waho o ke kino, kahi i hoʻopaʻa ʻia e ka mea i kapa ʻia ʻo gamma kamera.
