• Korean Journal of Clinical Laboratory Science
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• v.55 no.4
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• pp.261-268
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• 2023

[¹⁸F]Fluorocholine is a radiopharmaceutical used non-invasively in positron emission tomography to diagnose parathyroid adenoma, prostate cancer, and hepatocellular carcinoma by evaluating the choline metabolism. In this study, a radiolabeling method for [¹⁸F]fluorocholine was optimized using a solid phase extraction (SPE) cartridge. [¹⁸F]Fluorocholine was labeled in two steps using an automated synthesizer. In the first step, dibromomethane was reacted with [¹⁸F]KF/K2.2.2/K₂CO₃ to obtain the intermediate [¹⁸F]fluorobromomethane. In the second step, [¹⁸F]fluorobromomethane was passed through a Sep-Pak^Ⓡ Silica SPE cartridge to remove the impurities and then reacted with N,N-dimethylaminoethanol (DMAE) in a Sep-Pak^Ⓡ C18 SPE cartridge to label [¹⁸F]fluorocholine. The reaction conditions of [¹⁸F]fluorocholine were optimized. The synthesis yield was confirmed according to the number of silica cartridges and DMAE concentration. No statistically significant difference in the synthesis yield of [¹⁸F]fluorocholine was observed when using four or three silica cartridges (P>0.05). The labeling yield was 11.5±0.5% (N=4) when DMAE was used as its original solution. On the other hand, when diluted to 10% with dimethyl sulfoxide, the radiochemical yield increased significantly to 30.1±5.2% (N=20). In conclusion, [¹⁸F]Fluorocholine for clinical use can be synthesized stably in high yield by applying an optimized synthesis method.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.62-67
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• 2012

Purpose : At this time, the sentinel lymph node mapping using radioisotope and blue dye is preceded for breast cancer patient's sentinel lymph node biopsy. But all patients were applied the same protocol without consideration of physical specific character like the breast sizes and body mass indexes. The purpose of this study is search the optimized scan time in breast sentinel lymphangiography by observing how much the body mass index and breast size influence speed of lymphatic flow. Materials and Methods : The Object of this study was 100 breast cancer patients(Female, 100 persons, average age $50.34{\pm}10.26$ years old)at Severance hospital from October 2011 to December 2011. They were scanned breast sentinel lymphangiography before operation. This study was performed on Forte dual heads gamma camera (Philips Medical Systems, Nederland B.V.). All patients were intra-dermal injected $^{99m}Tc$-Phytate 18.5 MBq, 0.5 ml. For 80 patients, we have scanned without limitation of scan time until the lymphatic flow from the lymph node since injection. We measured how long the lymphatic flow time between departures from injects site and arrival to lymph node using stopwatch. After we calculated patient's Body mass Index and classified as 4 groups. And we measured patient's breast size and classified 3 groups. The modified breast lymphangiography that changing scan time according to comparison study's result was performed on 20 patients and was estimated. Results : The mean scan time as breast size was A group 2.48 minutes, B group 7.69 minutes, C group 10.43 minutes. The mean scan time as body mass index was under weight 1.35 minutes, normal weight 2.56 minutes, slightly over 5.62 minutes, over weighted 5.62 minutes. The success rate of modified breast lymphangiography was 85%. Conclusion : As the Body mass index became higher and breast size became bigger, the total scan time is increased. Based on the obtained information, we designed modified breast lymphangiography protocol. At the cases applying that protocol, most of sentinel lymph nodes were visualized as lymphatic pool. In conclusion, we found that the more success rate in modified protocol considering physical individuality than study carrying out in the same protocol.

• The Korean Journal of Nuclear Medicine
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• v.27 no.1
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• pp.112-117
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• 1993

Background Radioiodine ($^{131}I$), a major component of nuclear fallout and a valuable therapeutic agent for thyrotoxicosis and thyroid cancer, has been regarded as a mutagen or a carcinogen without any convincing evidence. To evaluate the genotoxicity of radioiodine ($^{131}I$) we performed a micronuclei test in mice bone marrow. Materials and methods : Mice (ICR strain, $25{\sim}30 g$) were divided to 4 groups: control, group 1 (0.17 mCi/kg, usual therapeutic dose for thyrotoxicosis), group 2 (1.67 mCi/kg, usual therapeutic dose for thyroid cancer), and group 3 (16.67 mCi/kg, usual accumulated dose causing bone marrow suppression). $^{131}I$ was administered intraperitoneally. Ten mice of each group were sacrificed at days 1 and 3. Bone marrow were smeared and stained with May-Grunwald Giemsa method. One thou-sand polychromatic erythrocytes (PCE) and normochromatic erythrocytes (NCE) were counted under the light microscope, and the number of micronucleated PCEs were recorded. Results : The frequency of micronuclei in PCE (and NCE in parenthesis) in the control group was $0.25{\pm}0.07$ ($0.23{\pm}0.07$)% in day 1 and $0.24{\pm}0.07$ ($0.21{\pm}0.07$)% in day 3. Those in group 1 was $0.27{\pm}0.1$ ($0.23{\pm}0.09$)% in day 1 and $0.28{\pm}0.07$ ($0.25{\pm}0.06$)% in day 3. Micronuclei was noted in $0.29{\pm}0.08$ ($0.26{\pm}0.09$)% in day 1 and $0.31{\pm}0.05$ ($0.29{\pm}0.06$)% in day 3 in group 2, and in $0.32{\pm}0.06$ ($0.25{\pm}0.09$)% in day 1 and $0.33{\pm}0.08$ ($0.3{\pm}0.06$)% in day 3 in group 3. There was no difference in the frequency of micronuclei between each groups (p> 0.05). Conclusion : Radioiodine ($^{131}I$) did not cause any genotoxicity in mice bone marrow even at the large dose (16.67 mCi/kg).

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.100-103
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• 2010

Purpose: $^{18}F$-FDG wholebody PET is to evaluate the tumor using glucose metabolism. The blood glucose level is important factor that affects on a result of examination. High glucose levels may interfere with tumor targeting due to competitive inhibition of FDG uptake by D-glucose. The blood glucose level measurement test strips used in the blood glucose measurement are classified into the capillary blood measurement test strips and general purpose measurement test strips that can measure the venous blood and capillary blood altogether depends on cases. The purpose of the study was to compare the blood glucose measurements between simultaneously obtained capillary and venous blood samples using the capillary blood measurement test strips, general purpose measurement test strips. Materials and Methods: A total of 46 subjects (32 males, 14 females) with a mean age of $57.3{\pm}12.3$ years were enrolled. The blood glucose estimation was performed with a Optium Xceed Glucometer (Abbott). Simultaneous capillary and venous blood samples were obtained from each subject. The blood glucose levels were measured using the capillary blood measurement test strips and general purpose measurement test strips. The capillary and venous measurements were compared using a pared t-test. Results: The mean capillary and venous glucose values using the general purpose measurement test strips were $95.2{\pm}12.4$ mg/dL and $104.1{\pm}14.4$ mg/dL, giving a statistically significant difference (p<0.001) between the mean values for the capillary and venous glucose samples (9.0 mg/dL; 95% confidence interval (CI) -11.2 to -6.7). The mean capillary and venous glucose values using the capillary blood measurement test strips were $91.5{\pm}13.6$ mg/dL and $108.6{\pm}16.2$ mg/dL, giving a statistically significant difference (p<0.001) between the mean values for the capillary and venous glucose samples (16.6 mg/dL; 95% CI -20.2 to -13.0). Conclusion: When measuring the blood glucose level before $^{18}F$-FDG PET examination, since the incorrect blood glucose level can be measured, it should note to measure the blood glucose level of the venous blood by the capillary blood measurement test strips. Therefore the measurement variation can be reduced to fulfill the standardized measurement procedure with the suitable measurement test strips, the preparation of the PET examination will be able to be clearly confirmed. In addition, the standardized procedure of the following measurement on the area which is same at all times the blood area in the blood glucose measurement among a capillary or a vein will be needed.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.9-13
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• 2016

Purpose PET-CT examinations using $^{18}F-FDG$ to treat urinary system cancer are limited in terms of anatomical structure and excretion route of $^{18}F-FDG$. But one of the ongoing examinations utilizing $^{11}C-Acetate$ can compensate for such defects. We would like to introduce a clinical application of $^{11}C-Acetate$ PET-CT in urinary cancer patients. Materials and Methods We conducted a clinical survey of 22 patients diagnosed with urinary cancer at our hospital, 10 prostate cancer patients, 10 renal cell carcinoma patients, and 2 bladder cancer patients. All patients were performed $^{18}F-FDG$ PET-CT examinations, $^{11}C-Acetate$ examinations were performed after two weeks on average. The equipment used to D-710 PET-CT in GE Company and we performed PET-CT procedures 15 minutes after injecting $^{11}C-Acetate$, and a medical doctor from the department of nuclear medicine appraised and compared images between $^{18}F-FDG$ and $^{11}C-Acetate$. Results According to our survey, prostate cancer patients generally had lower uptake of $^{18}F-FDG$ than other cancer patients did. In 2 out of 10 prostate cancer patients, metastasized cancer showed greater uptake in $^{11}C-Acetate$ than $^{18}F-FDG$. In renal cell carcinoma cases, 8 out of 10 patients displayed evidently greater uptake in $^{11}C-Acetate$ than $^{18}F-FDG$. We excluded bladder cancer cases in this study because uptake of $^{18}F-FDG$ in the bladder was too hot, the number of patients was insufficient, and the cases did not meet criteria such as the use of diuretics. Conclusion It is too premature to draw solid conclusions from the survey, since it involved only a small number of participants. However, there are a number of studies conducted abroad that prove the effectiveness of the $^{11}C-Acetate$ PET-CT examinations in treating urinary system cancer, and this study is still ongoing at our hospital. If the tests were to be conducted on a larger number of participants, this study could lead to numerous other potential research topics, such as the correlation between Prostatic specific antigen (PSA) values and $^{11}C-Acetate$ PET-CT, Gleason sum values from biopsy before surgery, Specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV) between $^{18}F-FDG$ PET-CT examinations and $^{11}C-Acetate$ PET-CT examinations in other urinary system cancers.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.140-144
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• 2014

Purpose: The recent surge in breast carcinoma patients is reported in a variety of statistics. Breast cancer occurs mainly from duct and lobulus: 85% is from the breast ducts. The present study is aimed to distinguish the difference in $SUV_{max}$ changing over time by identifying the type of cancers attacking from the duct. Materials and Methods: The subjects of the study are 291 female breast cancer patients who have visited the present PET/CT center from July 1, 2012 to July 23, 2013. Based on the pathological results, 248 IDC (invasive ductal carcinoma) patients and 43 DCIS (ductal carcinoma in situ) patients were selected. In the same manner as the general PET/CT scan (3.7 MBq/Kg), F-FDG was injected, followed by the primary test (Routine tests) after 1 hr, and the secondary test (Delay test) after another hr. $SUV_{max}$ was measured after setting ROI in the lesion based on the data from the two tests. Results: As the comparative result of the change in the lesion $SUV_{max}$ between the two groups, IDC group's $SUV_{max}$ showed M=7.11 and SD=5.405 in the primary test and increased M=7.11 and SD=5.405 in the secondary test (P<0.05); DCIS group's $SUV_{max}$ showed M=2.739, SD=1.229 in the primary test and increased M=2.614, SD=1.470 in the secondary test (P<0.05). Conclusion: As the comparative result of $SUV_{max}$ over time between the groups, IDC showed increased $SUV_{max}$ in the secondary test (Delay test) compared to the primary test (Routine test) (P=0.000); DCIS showed decreased $SUV_{max}$ in the secondary test (Delay test) compared to the primary test (Routine test) (P=0.039). It was confirmed through this study that the change in $SUV_{max}$ has occurred over time by the type of breast cancer (IDC or DCIS) occurring from the breast ducts. However, the onset of breast cancers (ILC, LCIS) from the lobulus was not discussed due to the lack of samples. Future research on the breast cancers from the lobulus is suggested.

• The Korean Journal of Nuclear Medicine Technology
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• v.23 no.1
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• pp.45-49
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• 2019

Purpose Lung Ventilation Scan(LVS) images directly inhaled radiation gas to evaluate lung ventilation ability. Therefore, it is influenced by various factors related to inhalation, including number of breaths, respiratory duration, respiration rate, and breathing method. In actual LVS examinations, it is difficult for objectify the patient's ability to inhale, and there is currently no known index related to inhalation. Therefore, this study confirms the correlation between counts per second(cps) in LVS and the results of pulmonary function test(PFT) and evaluate its usefulness as an objective indicator of inhalation. Materials and Methods From October 2010 to September 2018, 36 Chronic Obstructive Pulmonary Disease(COPD) patients who had both LVS and PFT were classified by severity(Mild, Moderate, Severe). LVS was performed by creating Technegas with Vita Medical's Technegas Generator and inhaling it to the patient. LVS images were acquired with Philips's Forte equipment., and PFT used Carefusion's Vmax Encore 22. The correlation between the cps measured by setting the region of interest(ROI) of both lungs on the LVS and the forced vital capacity(FVC), forced expiratory volume in one second($FEV_1$), $FEV_1/FVC$ of the results of PFT was compared and analyzed. Results We analyzed the correlation between cps of LVS using Technegas and the results of PFT by classifying COPD patients according to severity. Correlation coefficient between $FEV_1/FVC$ and cps was Severe -0.773, Moderate -0.750, and Mild -0.437. The Severe and Modulate result values were statistically significant(P<0.05) and Mild was not significant(P=0.155). On the other hand, the correlation coefficient between FVC and cps was statistically significant only in Mild and it was 0.882(P<0.05). Conclusion According to the study, we were able to analyze correlation between cps of LVS using Technegas and the results of PFT in COPD Patients. Using this result, when performing a LVS, the results of PFT can be used as an index of inhaling capacity. In addition, it is thought that it will be more effective for the operation of the exam rooms.

• The Korean Journal of Nuclear Medicine
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• v.27 no.2
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• pp.261-269
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• 1993

When monoclonal antibodies are used in radioimmunoassay or immunoscintigraphic studies, post-labelling immunoreativity is a critical parameter. $^{125}I$ was incorporated to CEA-79 (anti CEA monoclonal antibody developed in Korea) by chloramine T and iodogen method with variable specific activities from $0.1{\mu}Ci/{\mu}g$ to $100{\mu}Ci/{\mu}g$. We used a new method to evaluate the immunoreactivites of modified antibody relative to the unlabelled native antibody from competitive binding assay. The effect of immunoreactivity and specific activity to the sensitivity of radioimmunometric assay was also evaluated. As a result, chloramine T method was better than iodogen method in radioiodination of CEA-79, because the immunoreactivity of antibody was relatively well reserved and more stable. New competitive binding assay was simple and effective to evaluate the change of immunoreactivity in radiolabelling. Antibody with high immunoreactivity and high specific activity improved the sensitivity of radioimmunometric assay, whereas antibody with high specific activity but low immunoreactivity didn't. The immunoreactivity and specific activity should be optimized according to the clinical un, and competitive binding method is useful in selection of optimal radiolabelling assay.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.2
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• pp.221-234
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• 2019

Cancer is genetically, metabolically and infectiously induced life threatening disorder showing aggressive growing pattern with invasive tendency. In order to prevent this global menace from jeopardizing human life, enormous studies on carcinogenesis and treatment for chemotherapy resistance have been intensively researched. Hinokitiol (${\beta}$-thujaplicin) extracted from heart wood of cupressaceous is a well-known bioactive compound demonstrating anti-inflammation, anti-bacteria and anti-cancer effects on several cancer types via apoptosis and autophagy. This study proposed that hinokitiol activates transcription factor EB (TFEB) nuclear translocation for autophagy and lysosomal biogenesis regardless of nutrient condition in cancer cells. Mitophagy and ${\beta}$-catenin translocation into the nucleus under treatment of hinokitiol on non-small cell lung cancer (NSCLC) cells and HeLa cells were investigated. Hinokitiol exerted cytotoxicity on HeLa and HCC827 cells; moreover, artificially induced autophagy by overexpression of TFEB granted imperfect sustainability onto HeLa cells. Taken together, hinokitiol is the prominent autophagy inducer and activator of TFEB nuclear translocation. Alternative cancer therapy via autophagy is pros and cons since the autophagy in cancer cells is related to prevention and survival mechanism depending on nutrition. To avoid paradox of autophagy in cancer therapy, fine-tuned regulation and application of hinokitiol in due course for successful suppressing cancer cells are recommended.

• Korean Journal of Clinical Laboratory Science
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• v.55 no.4
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• pp.284-290
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• 2023

Adefovir dipivoxil (ADV) is used for the treatment of hepatitis and acquired immunodeficiency syndrome, but long-term use can cause osteoporosis. In this study, the effect of ADV on the osteocyte maturation process was evaluated at the level of undifferentiated cells using mesenchymal stem cells (MSCs) and osteoblasts (MG63). First, MSCs and MG63 cells were treated with ADV at different concentrations, and then a Cell Counting Kit-8 analysis was performed to determine the effect on the proliferation of each cell. Additionally, crystal violet and Hoechst staining were performed for the morphological analysis of each cell and nucleus. To determine the cause of cell hypertrophy, the transforming growth factor-beta (TGF-β) expression was investigated, and alkaline phosphatase (ALP) staining and activity were measured to determine the degree of differentiation of the MSCs and MG63 cells into mature osteocytes. The results confirmed that the ADV increases the expression of TGF-β in MSCs and MG63 cells, causing cellular and nuclear hypertrophy, and can cause osteoporosis by inhibiting cell proliferation and affecting the differentiation of mature osteocytes. Therefore, it is believed that these results can be used as a basis for understanding the adverse effects of ADV at a cytological level in basic medicine and clinical research.