• Nuclear Medicine and Molecular Imaging
• /
• v.43 no.4
• /
• pp.253-258
• /
• 2009

Bone scintigraphy using $^{99m}$Tc-labeled phosphate agents has long been the standard evaluation method for whole skeletal system. However, recent shortage of $^{99m}$Tc supply and advanced positron emission tomography (PET) technology evoked the attention to surrogate radiopharmaceuticals and imaging modalities for bone. Actually, fluorine-18 ($^{18}$F) was the first bone seeking radiotracer before the introduction of $^{99m}$Tc-labeled agents even though its clinical application failed to become pervasive anymore after the rapid spread of Anger type gamma camera systems in early 1970s. However, rapidly developed PET technology made us refocus on the usefulness of $^{18}$F as a PET tracer. Early study comparing $^{18}$F-Na PET scan and planar bone scintigraphy reported that PET has higher sensitivity and specificity in the diagnosis of metastatic bone lesions than planar bone scan. Subsequent reports comparing between PET and both planar and SPECT bone image also revealed better results of PET scan in similar study groups. Rapid clinical application of PET/CT also accumulated considerable amount of experiences in skeletal evaluation and this modality is known to have better diagnostic power than stand alone PET system as well as bone scan. Furthermore $^{18}$F-Na PET/CT revealed better or at least equal results in detection of primary and metastatic bone lesions compared with CT and MRI. Therefore, it is obvious that $^{18}$F-Na PET/CT has potential to become new imaging modality for practical skeletal evaluation so continuous and careful evaluation of this modality and radiopharmaceutical must be required.

• Journal of Radiopharmaceuticals and Molecular Probes
• /
• v.7 no.2
• /
• pp.147-152
• /
• 2021

C-11 Radiolabeled amino acid-based radiopharmaceuticals such as [¹¹C]MET for brain tumor PET imaging have limitations due to their short half-life (20 min). F-18 radiolabeled amino acid derivatives have been developed to overcome for the short half-life, one of which is [¹⁸F]FET. Brain tumor imaging using [¹⁸F]FET showed high uptake in tumor region and no non-specific uptake in inflammatory tissue, which was useful in discriminating the difference between inflammation and tumor especially. In this study, [¹⁸F]FET was synthesized using an automatic synthesis module and quality tests were carried out including enantiomeric purity analysis with reference compounds. Radiochemical yield was 50.3 ± 4.9% (n=7, decay-corrected) with molar activity of 76 ± 17 GBq/mmol. The radiochemical purity of >99%. Enantiomeric purity of [¹⁸F]FET using chiral HPLC analysis showed >99%, which was confirmed by co-injection with the L-FET and D-FET authentic standards. [¹⁸F]FET was prepared with high radiochemical yield and molar activity including no racemate mixture.

• Nuclear Medicine and Molecular Imaging
• /
• v.43 no.6
• /
• pp.543-556
• /
• 2009

Purpose: We studied the patterns of FDG uptake of primary papillary thyroid microcarcinoma (PTMCa) lesions and benign thyroid nodules in dual time point $^{18}F$-FDG PET/CT imaging. Materials and Methods: Consecutive 134 patients (154 lesions) with PTMCa and 49 patients (61 nodules) with benign thyroid nodules equal to or less than 1.0 cm who underwent dual time point $^{18}F$-FDG PET/CT study before surgery were enrolled. We calculated the maximum standardized uptake value of PTMCa and benign nodules in both time points, and percent change of SUVmax (${\Delta}%SUVmax$) and lesion to background ratio of SUVmax (${\Delta}L:B$% ratio) between both time points. The mean time interval between scans was $23.4{\pm}4.4$ minutes (thyroid to thyroid interval: $10.7{\pm}4.4$ minutes). Results: The mean of SUVmax of PTMCa was increased from $4.9{\pm}4.3$ to $5.3{\pm}4.7$ (p<0.001) and ${\Delta}%SUVmax$ was $12.3{\pm}23.6%$. But, the mean of SUVmax of benign nodules was no definite change ($2.1{\pm}1.0$ to $2.1{\pm}1.3$, p=0.686) and ${\Delta}%SUVmax$ was $-0.3{\pm}20.5%$. Of the 154 PTMCa, 100 nodules (64.9%) showed an increase in SUVmax over time, while 19 (31.1%) of the 61 benign thyroid nodules showed an increase (p<0.001). The dual time point $^{18}F$-FDG PET/CT found more PTMCa in visual assessment (62.3% vs. 76.6%, p=0.006), even in smaller than 0.5 cm (38.6% vs. 60.0%, p=0.011). Conclusion: Dual time time $^{18}F$-FDG PET/CT imaging was more useful than single time point $^{18}F$-FDG PET/CT imaging for distinction between PTMCa and benign nodule, especially when nodule showed equivocal or negative findings in single time point $^{18}F$-FDG PET/CT imaging or was smaller than 0.5 cm.

• Nuclear Medicine and Molecular Imaging
• /
• v.43 no.5
• /
• pp.411-420
• /
• 2009

Purpose: The aim of this study was to investigate the usefulness of $^{18}F$-FDG PET/CT with neck ultrasonography (neck US) in patients with recurrent, papillary thyroid cancer. Material and methods: This retrospective study (December 2006 to April 2008) enrolled sixty-one patients (ninety-one lesions) who underwent high-dose $^{131}I$-ablation therapy after total thyroidectomy, and evaluated recurred papillary thyroid cancer. All lesions were confirmed by histopathology and compared histopathologic findings to PET, PET/CT, and neck US findings. Results: In sixty-one patients (57 women, 4 men; age range, 24-81 years, mean 49 years; 61 papillary carcinomas), the sensitivity, specificity, accuracy of $^{18}F$-FDG PET/CT was 87.2%, 64.0%, 78.1% on a patient basis and 92.3%, 66.7%, 80.9% on a lesion basis, respectively. The sensitivity, specificity, accuracy of $^{18}F$-FDG PET was 71.8% (p=0.03), 59.0% (p=1.00), 67.2% (p=0.03) on a patient basis and 78.8% (p<0.01), 64.1% (p=1.00), 72.5% (p=0.02) on a lesion basis, respectively. The sensitivity, specificity, accuracy of neck US was 71.1% (p=0.07), 52.2% (p=0.75), 63.9% (p=0.05) on a patient basis and 71.2% (p<0.01), 61.5% (p=1.00), 67.0% (p=0.06) on a lesion basis, respectively. Combined $^{18}F$-FDG PET/CT with neck US improved the sensitivity, specificity, accuracy to 94.7% (p=0.50), 82.6% (p=0.13), 90.2% (p=0.03) on a patient basis and 96.2% (p=0.50), 89.7% (p<0.01), 93.4% (p<0.01) on a lesion basis, respectively. Conclusion: $^{18}F$-FDG PET/CT demonstrated significantly higher sensitivity than neck US for the detection of recurred papillary thyroid cancer lesions. Furthermore, combined $^{18}F$-FDG PET/CT with neck US showed more improved sensitivity, specificity, accuracy for diagnosis of recurrent papillary thyroid cancer.

• Nuclear Medicine and Molecular Imaging
• /
• v.42 no.6
• /
• pp.456-463
• /
• 2008

Purpose: We evaluated the incidence and malignant risk of focal breast lesions incidentally detected by $^{18}F-FDG$ PET/CT. Various PET/CT findings of the breast lesions were also analyzed to improve the differentiation between benign from malignant focal breast lesions. Materials & Methods: The subjects were 3,768 consecutive $^{18}F-FDG$ PET/CT exams performed in adult females without a history of breast cancer. A focal breast lesion was defined as a focal $^{18}F-FDG$ uptake or a focal nodular lesion on CT image irrespective of $^{18}F-FDG$ uptake in the breasts. The maximum SUV and CT pattern of focal breast lesions were evaluated, and were compared with final diagnosis. Results: The incidence of focal breast lesions on PET/CT in adult female subjects was 1.4% (58 lesions in 53 subjects). In finally confirmed 53 lesions of 48 subjects, 11 lesions of 8 subjects (20.8%) were proven to be malignant. When the PET/CT patterns suggesting benignancy (maximum attenuation value>75 HU or <30HU; standard deviation of mean attenuation > 20) were added as diagnostic criteria of PET/CT to differentiate benign from malignant breast lesions along with maximum SUV, the area under ROC curve of PET/CT was significantly increased compared with maximum SUV alone ($0.680{\pm}0.093$ vs. $0.786{\pm}0.076$, p<0.05). Conclusion: The malignant risk of focal breast lesions incidentally found on $^{18}F-FDG$ PET/CT is not low, deserving further diagnostic confirmation. Image interpretation considering both $^{18}F-FDG$ uptake and PET/CT pattern may be helpful to improve the differentiation from malignant and benign focal breast lesion.

• The Journal of the Korea Contents Association
• /
• v.15 no.9
• /
• pp.418-424
• /
• 2015

In this study, we proceed if there are any changes in binding ability of receptor-ligand in some degree of SA and in radioactive uptake from the corpus striatum based on small animal experiment in vivo based on the S.A values. By dividing 18F-Fallypride into 3 S.A values(high S.A : 43.29~74 GBq/umol, ordinary S.A : 20.72~29.23 GBq/umol, low S.A : 6.29~8.51 GBq/umol), we injected directly into the veins and performed 90 minutes of dynamic scan using Micro PET. After scanning, we compared and analyzed with Binding Potential (Binding Potential) from the bilateral striatum. high SA and low SA, ordinary SA and low SA showed significant differences. Also, in the image comparison using 18F-Fallypride show high radioactive uptake in the striatum at high SA and ordinary SA, but the radioactive uptake at low SA is lower than other two SA. Since 18F-Fallypride has affinity to dopamine D2/3 pharmacokinetic, the difference of Binding Potentials at decreased level of SA values was not that significant. However, further PET research of the corpus striatum using 18F-Fallypride is necessary because the differences in images and Binding Potentials at 6.5 times smaller SA values compared to high SA value showed were significant.

• Clinical and Experimental Pediatrics
• /
• v.57 no.6
• /
• pp.278-286
• /
• 2014

Purpose: To evaluate the potential utility of $^{123}I$-metaiodobenzylguanine ($^{123}I$-MIBG) scintigraphy and $^{18}F$-fluorodeoxyglucose ($^{18}F$-FDG) positron emission tomography (PET) for the detection of primary and metastatic lesions in pediatric neuroblastoma (NBL) patients, and to determine whether $^{18}F$-FDG PET is as beneficial as $^{123}I$-MIBG imaging. Methods: We selected 8 NBL patients with significant residual mass after operation and who had paired $^{123}I$-MIBG and $^{18}F$-FDG PET images that were obtained during the follow-up. We retrospectively reviewed the clinical charts and the findings of 45 paired scans. Results: Both scans correlated relatively well with the disease status as determined by standard imaging modalities during follow-up; the overall concordance rates were 32/45 (71.1%) for primary tumor sites and 33/45 (73.3%) for bone-bone marrow (BM) metastatic sites. In detecting primary tumor sites, $^{123}I$-MIBG might be superior to $^{18}F$-FDG PET. The sensitivity of $^{123}I$-MIBG and $^{18}F$-FDG PET were 96.7% and 70.9%, respectively, and their specificity were 85.7% and 92.8%, respectively. $^{18}F$-FDG PET failed to detect 9 true NBL lesions in 45 follow-up scans (false negative rate, 29%) with positive $^{123}I$-MIBG. For bone-BM metastatic sites, the sensitivity of $^{123}I$-MIBG and $^{18}F$-FDG PET were 72.7% and 81.8%, respectively, and the specificity were 79.1% and 100%, respectively. $^{123}I$-MIBG scan showed higher false positivity (20.8%) than $^{18}F$-FDG PET (0%). Conclusion: $^{123}I$-MIBG is superior for delineating primary tumor sites, and $^{18}F$-FDG PET could aid in discriminating inconclusive findings on bony metastatic NBL. Both scans can be complementarily used to clearly determine discrepancies or inconclusive findings on primary or bone-BM metastatic NBL during follow-up.

• Molecular & Cellular Toxicology
• /
• v.3 no.3
• /
• pp.198-207
• /
• 2007

[ $^{18}F$ ]-fluorodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan has been found to reflect tumor aggressiveness and prognosis in various types of cancer. In this study, the gene expression profiles of glial tumors were evaluated to determine whether glial tumors with high $^{18}F$-FDG uptake have more aggressive biological potential than with low uptake. Surgical specimens were obtained from the 12 patients with glial tumors (4 males and 8 females, age range 42-68 years). The tumor samples were divided into two groups based on the $^{18}F$-FDG uptake PET scan findings: high $^{18}F$-FDG uptake (n=4) and low $^{18}F$-FDG uptake (n=8). The pathological tumor grade was closely correlated with the $^{18}F$-FDG uptake pattern: Glial tumors with high $^{18}F$-FDG uptake were pathologically Edmondson-Steiner grade III, while those with low uptake were grade II. The total RNA was extracted from the frozen tissues of all glial tumors (n=12), and adjacent non-cancerous tissue (n=3). The gene expression profiles were evaluated using cDNA microarray. The glial tumors with high $^{18}F$-FDG uptake showed increase expression of 15 genes compared to those with low uptake (P<0.005). Nine genes were down-regulated. Gene expression is closely related to cell survival, cell-to-cell adhesion or cell spreading; therefore, glial tumors with high $^{18}F$-FDG uptake appear to have more aggressive biological properties than those with low uptake.

• Journal of Radiopharmaceuticals and Molecular Probes
• /
• v.9 no.1
• /
• pp.17-21
• /
• 2023

In this study, we evaluated the targeting of prostate cancer (PCa) using [¹⁸F]Florastamin in non-clinical study, for the purpose of therapeutic monitoring of [¹⁷⁷Lu]Ludotadipep, a therapeutic radiopharmaceutical for PCa, [¹⁸F]Florastamin/[¹⁷⁷Lu]Ludotadipep was co-administered to a single-individual prostate tumor bearing mouse model, mimicking clinical condition. Considering the difference in half-life of the two isotopes (¹⁸F or ¹⁷⁷Lu), image scan of whole-body autoradiography was performed at 24 or 48 h after preparation of frozen section, respectively. Then, it was confirmed whether they showed the same targeting efficiency for the area of tumor. A tumor xenograft model was prepared using PSMA-overexpressing PC3-PIP prostate cancer cells. [¹⁸F]Florastamin [111 MBq (3 mCi) in 100 µL]/¹⁷⁷Lu]Ludotadipep [3.7 MBq (100 µCi) in 100 µL] was co-administered through the tail vein, and 2 hours after administration, the mice were frozen, and after freezing for 24 hours, whole-body cryosection was performed at 24 h after freezing. Image scanning using cryosection was performed after 24 or 48 hours after freezing, respectively. In the scan image after 24 hours, tumor uptake of [¹⁸F] Florastamin/[¹⁷⁷Lu]Ludotadipep were simultaneously observed specific uptake in the tumor. In the scan image after 48 hours in the same section, signal of ¹⁸F was lost by decay of radioisotope, and specific uptake image for [¹⁷⁷Lu]Ludotadipep was observed in the tumor. Uptake of [¹⁷⁷Lu]Ludotadipep was specific to the same tumor region where [¹⁸F]Florastamin/[¹⁷⁷Lu]Ludotadipep was uptake. These results suggested that [¹⁸F]Florastamin showed the same tumor uptake efficiency to PCa as [¹⁷⁷Lu]Ludotadipep, and effective therapeutic monitoring is expected to be enable using [¹⁸F]Florastamin during [¹⁷⁷Lu]Ludotadipep therapy for PCa.

• Korean Journal of Clinical Laboratory Science
• /
• v.39 no.3
• /
• pp.249-255
• /
• 2007

While respiratory burst enhances neutrophil glucose utilization, many neutrophil functions are critically influenced by extracellular matrix interaction and phosphoinositide-3-OH kinase (PI3K) signaling. We thus evaluated the role of RGD integrin occupancy and PI3K inhibition on respiratory burst and [18F]FDG uptake of stimulated neutrophils. Human neutrophils were stimulated by 100 ng/mL phorbol-myristate-acetate (PMA), and respiratory burst was measured by cumulative luminescence with lucigenin. [18F]FDG uptake and total hexokinase activity was measured 20 min after PMA stimulation in the presence or absence of soluble RGD peptides (200 g/mL) and/or the PI3K inhibitor wortmannin (200 nM). PMA induced a 71.70.9 fold increase in neutrophil oxygen intermediate generation. [18F]FDG uptake was increased to $194.6{\pm} 3.7%$ and hexokinase activity to $145.0{\pm}2.0%$ of basal levels (both p<0.0005). RGD peptides attenuated respiratory burst activation to $35.6{\pm}0.2%$ (p<0.005), but did not inhibit stimulated [18F]FDG uptake or hexokinase activity. In contrast, without affecting respiratory burst activation, wortmannin inhibited PMA stimulated [18F]FDG uptake to $66.9{\pm}1.6%$ and hexokinase activity to $81.0{\pm}4.2%$ (both P<0.0005), demonstrating its dependence on PI3K activity. Neither RGD nor wortmannin reversed the other's inhibitory effect on stimulated [18F]FDG uptake and hexokinase activity or respiratory burst, which suggests the involvement of distinct signaling pathways. Neutrophil [18F]FDG uptake is enhanced by PMA through a mechanism that requires PI3K activity but is independent of integrin receptor occupancy or respiratory burst activation.