• Nuclear Medicine and Molecular Imaging
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• v.43 no.4
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• pp.352-356
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• 2009

Intravascular large B-cell lymphoma (IVLBCL) is a subtype of diffuse large cell lymphoma, characterized by proliferation of lymphoid cells in the intravascular space of various organs without causing a mass effect. Although $^{18}$F-FDG PET is a powerful imaging tool in lymphoma, the usefulness of $^{18}$F-FDG PET in the assessment of IVLBCL is still controversial. $^{99m}$Tc-MIBI, a tumor imaging radiopharmaceutical with a different mechanism from that of $^{18}$F-FDG, has been reported to be also effective in lymphoma. However, there is nearly no report on the efficacy of $^{99m}$Tc-MIBI in the assessment of IVLBCL. We present one case of IVLBCL that showed $^{99m}$Tc-MIBI accumulation in the involved bone marrow as an incidental finding, which was discrepant from that of $^{18}$F-FDG PET.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.4
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• pp.333-336
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• 2008

A 52-year-old woman with a history of general weakness, fatigue, weight loss, elevated serum levels of liver transaminase enzyme for three months underwent an F-18 FDG PET/CT scan to evaluate a cause of the hepatosplenomegaly found on abdominal ultrasonography. Initial PET/CT revealed markedly enlarged liver and spleen with intense FDG uptake. Otherwise, there were no areas of abnormal FDG uptake in whole body image. Histological evaluation by a hepatic needle biopsy demonstrated diffuse large B cell type lymphoma and final diagnosis for this patient was hepatosplenic B-cell lymphoma. She received five cycles of CHOP chemotherapy, and second PET/CT scan was followed after then. Follow-up PET-CT revealed normal sized liver with disappearance of abnormal FDG uptake. Hepatosplenic B-cell lymphoma is relatively rare and mostly presents as single or multiple nodules.1,2 Diffuse type hepatosplenic lymphoma is extremely rare and poorly recognized entity.3 The diagnosis is very difficult and complicated by the presence of misleading symptoms.4 In this rare hepatosplenic B-cell lymphoma case, F-18 FDG PET/CT scan provided a initial diagnostic clue of hepatosplenic lymphoma and an accurate chemotherapy response.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.52-59
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• 2008

In the management of colo-retal and anal cancer, accurate staging, treatment evaluation, early detection of recurrence are main clinical problems. F-18 FDG PET (PET/CT) has been reported as useful in the management of colo-rectal and anal cancer because that PET has high diagnostic performance comparing to conventional studies. In case of liver metastases, for confirmation of no extrahepatic metastases, in case of high risk of metastasis, for avoiding unnecessary operation, PET (PET/CT) is expected more useful. In anal cancer, PET is expected useful in lymph node staging. For the early prediction of chemotherapy or radiation therapy effect PET has been reported as useful, also. In early detection of recurrence by PET, cost-benefit advantages has been suggested, also. PET/CT is expected to have higher diagnostic performance than PET alone.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.157-161
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• 2008

Malignant pleural mesothelioma (MPM) has a poor prognosis and a strong association with exposure to asbestos. Although there are not generally accepted guidelines for treatment of MPM, recent reports suggest that multi modality therapy combining chemotherapy, radiotherapy, and surgery can improve the survival of patients with MPM. Therefore exact staging is required to decide the best treatment option. However, it is well known that there are many difficulties in determining precise preoperative stage, predicting prognosis, and monitoring response to therapy with conventional imaging modalities such as CT and MRI in MPM. Recently PET with $^{18}F-FDG$ comes into the spotlight as an important staging method. There is increasing evidence that PET is superior to other conventional imaging modalities in diagnosis and staging of MPM. Particularly PET/CT improves the diagnostic and staging accuracy over PET or CT alone in MPM because it provides anatomic imaging data as well as functional information. PET and PET/CT are also useful for monitoring response to therapy and SUV is reported as a prognostic factor in MPM.

• The Korean Journal of Nuclear Medicine Technology
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• v.28 no.1
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• pp.41-47
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• 2024

Purpose: ¹⁸F-FET, a radiopharmaceutical based on a Tyrosine amino acid derivative using the Sodium-Potassium Pump-independent Transporter (System L) for non-invasive evaluation of primary, recurrent, and metastatic brain tumors, exhibits distinct characteristics. Unlike the widely absorbed ¹⁸F-FDG in both tumor and normal brain tissues, ¹⁸F-FET demonstrates specific uptake only in tumor tissue while almost negligible uptake in normal brain tissue. This study aims to compare and evaluate the usefulness of ¹⁸F-FDG and ¹⁸F-FET Brain PET/CT quantitative analysis in brain tumor diagnosis. Materials and Methods: In 46 patients diagnosed with brain gliomas (High Grade: 34, Low Grade: 12), Brain PET/CT scans were performed at 40 minutes after ¹⁸F-FDG injection and at 20 minutes (early) and 80 minutes (delay) after ¹⁸F-FET injection. SUV_max and SUV_peak of tumor areas corresponding to MRI images were measured in each scan, and the SUV_max-to-SUV_peak ratio, an indicator of tumor prognosis, was calculated. Differences in SUV_max, SUV_peak, and SUV_max-to-SUV_peak ratio between ¹⁸F-FDG and ¹⁸F-FET early/delay scans were statistically verified using SPSS (ver.28) package program. Results: SUV_max values were 3.72±1.36 for ¹⁸F-FDG, 4.59±1.55 for ¹⁸F-FET early, and 4.12±1.36 for ¹⁸F-FET delay scans. The highest SUV_max was observed in ¹⁸F-FET early scans, particularly in HG tumors (4.85±1.44), showing a slightly more significant difference (P<0.0001). SUV_peak values were 3.33±1.13 for ¹⁸F-FDG, 3.04±1.11 for ¹⁸F-FET early, and 2.80±0.96 for ¹⁸F-FET delay scans. The highest SUV_peak was in ¹⁸F-FDG scans, while the lowest was in ¹⁸F-FET delay scans, with a more significant difference in HG tumors (P<0.001). SUV_max-to-SUV_peak ratio values were 1.11±0.09 for ¹⁸F-FDG, 1.54±0.22 for ¹⁸F-FET early, and 1.48±0.17 for ¹⁸F-FET delay scans. This ratio was higher in ¹⁸F-FET scans for both HG and LG tumors (P<0.0001), but there was no statistically significant difference between ¹⁸F-FET early and delay scans. Conclusion: This study confirms the usefulness of early and delay scans in ¹⁸F-FET Brain PET/CT examinations, particularly demonstrating the changes in objective quantitative metrics such as SUV_max, SUV_peak, and introducing the SUV_max-to-SUV_peak ratio as a new evaluation metric based on the degree of tumor malignancy. This is expected to further contributions to the quantitative analysis of Brain PET/CT images.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.20
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• pp.8699-8703
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• 2014

18-fluoro-2-deoxyglucose positron emission tomography-computed tomography ($^{18}F$-FDG PET/CT) scans are commonly used for the staging and restaging of various malignancies, such as head and neck, breast, colorectal and gynecological cancers. However, the value of FDG PET/CT for detecting prostate cancer is unknown. The aim of this study was to evaluate the clinical value of incidental prostate $^{18}F$-FDG uptake on PET/CT scans. We reviewed $^{18}F$-FDG PET/CT scan reports from September 2009 to September 2013, and selected cases that reported focal/diffuse FDG uptake in the prostate. We analyzed the correlation between $^{18}F$-FDG PET/CT scan findings and data collected during evaluations such as serum prostate-specific antigen (PSA) levels, digital rectal examination (DRE), transrectal ultrasound (TRUS), and/or biopsy to confirm prostate cancer. Of a total of 18,393 cases, 106 (0.6%) exhibited abnormal hypermetabolism in the prostate. Additional evaluations were performed in 66 patients. Serum PSA levels were not significantly correlated with maximum standardized uptake values (SUVmax) in all patients (rho 0.483, p=0.132). Prostate biopsies were performed in 15 patients, and prostate cancer was confirmed in 11. The median serum PSA level was 4.8 (0.55-7.06) ng/mL and 127.4 (1.06-495) ng/mL in the benign and prostate cancer groups, respectively. The median SUVmax was higher in the prostate cancer group (mean 10.1, range 3.8-24.5) than in the benign group (mean 4.3, range 3.1-8.8), but the difference was not statistically significant (p=0.078). There was no significant correlation between SUVmax and serum PSA, prostatic volume, or Gleason score. $^{18}F$-FDG PET/CT scans did not reliably differentiate malignant or benign from abnormal uptake lesions in the prostate, and routine prostate biopsy was not usually recommended in patients with abnormal FDG uptake. Nevertheless, patients with incidental prostate uptake on $^{18}F$-FDG PET/CT scans should not be ignored and should be undergo further clinical evaluations, such as PSA and DRE.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.1
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• pp.110-114
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• 2014

Purpose: The advancement in PET/CT test devices has decreased the test time and popularized the test, and PET/CT tests have continuously increased. However, this increases the exposure dose of radiation workers, too. This study aims to measure the radiation shielding rate of $^{18}F-FDG$ with a strong energy and the shielding effect when worker wore an apron during the PET/CT test. Also, this study compared the shielding rate with $^{99m}TC$ to minimize the exposure dose of radiation workers. Materials and Methods: This study targeted 10 patients who visited in this hospital for the PET/CT test for 8 days from May 2nd to 10th 2013, and the $^{18}F-FDG$ distribution room, patient relaxing room (stand by room after $^{18}F-FDG$ injection) and PET/CT test room were chosen as measuring spots. Then, the changes in the dose rate were measured before and after the application of the APRON. For an accurate measurement, the distance from patients or sources was fixed at 1M. Also, the same method applied to $^{99m}TC's$ Source in order to compare the reduction in the dose by the Apron. Results: 1) When there was only L-block in the $^{18}F-FDG$ distribution room, the average dose rate was $0.32{\mu}Sv$, and in the case of L-blockK+ apron, it was $0.23{\mu}Sv$. The differences in the dose and dose rate between the two cases were respectively, $0.09{\mu}Sv$ and 26%. 2) When there was no apron in the relaxing room, the average dose rate was $33.1{\mu}Sv$, and when there was an apron, it was $22.3{\mu}Sv$. The differences in the dose and dose rate between them were respectively, $10.8{\mu}Sv$ and 33%. 3) When there was no APRON in the PET/CT room, the average dose rate was $6.9{\mu}Sv$, and there was an APRON, it was $5.5{\mu}Sv$. The differences in the dose and dose rate between them were respectively, $1.4{\mu}Sv$ and 25%. 4) When there was no apron, the average dose rate of $^{99m}TC$ was $23.7{\mu}Sv$, and when there was an apron, it was $5.5{\mu}Sv$. The differences in the dose and dose rate between them were respectively, $18.2{\mu}Sv$ and 77%. Conclusion: According to the result of the experiment, $^{99m}TC$ injected into patients showed an average shielding rate of 77%, and $^{18F}FDG$ showed a relatively low shielding rate of 27%. When comparing the sources only, $^{18F}FDG$ showed a shielding rate of 17%, and $^{99m}TC$'s was 77%. Though it had a lower shielding effect than $^{99m}TC$, $^{18}F-FDG$ also had a shielding effect on the apron. Therefore, it is considered that wearing an apron appropriate for high energy like $^{18}F-FDG$ would minimize the exposure dose of radiation workers.

• 대한방사선방어학회:학술대회논문집
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• 2010.04a
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• pp.142-143
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• 2010

• Proceedings of the Korean Nuclear Society Conference
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• 1999.05a
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• pp.403-403
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• 1999

• Nuclear Medicine and Molecular Imaging
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• v.43 no.6
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• pp.588-591
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• 2009

A 26-year-old man with renal cell carcinoma underwent $^{99m}Tc$-HDP bone scintigraphy for detecting bony metastasis after left total nephrectomy for renal cell carcinoma. $^{99m}Tc$-HDP bone scintigraphy showed small hot lesion in the first lumbar spine. About 12 months later, he underwent spinal MRI for lower back pain. A large mass was seen around spinous process of the first lumbar spine (L1) on spinal MRI and confirmed as metastatic renal cell carcinoma by bone biopsy. $^{99m}Tc$-HDP bone scintigraphy and $^{18}F$-FDG PET/CT were underwent for further evaluation. $^{99m}Tc$-HDP bone scintigraphy showed cold lesion in the first lumbar spine which was initially hot and newly developed hot lesion in the twelfth thoracic spine, and which were shown as hypermetabolic lesions in $^{18}F$-FDG PET/CT. We report a case of bony metastasis from renal cell carcinoma which is changed from hot lesion to cold lesion in $^{99m}Tc$-HDP bone scintigraphy and compare with $^{18}F$-FDG PET/CT.