• Nuclear Medicine and Molecular Imaging
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• v.41 no.1
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• pp.66-67
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• 2007

POEMS syndrome is a rare disorder, also known as Crow-Fukase, PEP or Takatsuki syndrome. The acronym, POEMS, represents polyneuropathy, organomegaly, endocrinopathy, M protein and skin change. However, there are associated features not included in the acronym such as sclerotic bone lesions, Castleman disease, papilledema, thromobocytosis, peripheral edema, ascites, effusion, polycythemia, fatigue and clubbing. In most cases, osseous lesions in POEMS syndrome present as an isolated sclerotic deposit and that reveal as osteosclerotic myeloma. Several cases of $^{18}F-FDG$ PET in multiple myeloma involvements were reported, but there was no previous literature that reported FDG PET findings in POEMS syndrome. We describe here a 66-year-old patient with POEMS syndrome who underwent $^{18}F-FDG$ PET/CT image.

• 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.

• The Korean Journal of Nuclear Medicine Technology
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• v.18 no.2
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• pp.68-72
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• 2014

Purpose The nuclear medicine examination, there is a difficulty to carry out the inspection of both on the day of residual isotope due to the half-life. In this study, by studying the mutual influence and $^{18}F$-FDG of $^{99m}TcO_4{^-}$, I would like to explain the matters to be considered in the case of performing the same day. Materials and Methods With the NEMA-1994 Phantom, and experiments were performed 3 times. Create a 1: 4 Background ratio HOT and the $^{99m}TcO_4{^-}$ The first experiment: After underwent SPECT in INFINIA (GE Healthcare, MI, USA), and were injected with $^{18}F$-FDG 37 MBq in the Background area, 13 once for 60 minutes under the same conditions was time Scan. Create a 1: 4 Background ratio HOT and the $^{18}F$-FDG second is: The Scan in PET/CT Discovery 600 (GE Healthcare, MI, USA), and 148 MBq after injection $^{99m}TcO_4{^-}$ the Background area, once for 60 minutes, 6 under the same conditions was time Scan. Create a 1: 4 Background ratio HOT and the $^{18}F$-FDG experiments las, increments of 296 MBq and 148 MBq the 1 Bed Scan after $^{99m}TcO_4{^-}$, was 1 Bed Scan under the same conditions. Non BKG area and HOT, I was measured comparing the Total Counts and SNR or CNR. Results Showed a significant difference in the ratio CNR of enforcement during SPECT $^{18}F$-FDG is, (p>0.05). The $^{99m}TcO_4{^-}$ was no significant difference between the SNR ratio of PET / CT at the time of the effective date (p<0.05). I got the results $^{99m}TcO_4{^-}$ that reduce the Total Counts of PET / CT scan. Conclusion If you make a PET / CT scan, may affect the test using the $^{99m}TcO_4{^-}$ up to 12 hours, when it is performed before the $^{99m}TcO_4{^-}$, does not affect the SNR and SUV, PET / CT scan I reduced the detection efficiency. The inspection of day, we'd like to recommend a way to complement the detection efficiency to increase the inspection time of PET / CT in move forward the inspection using the $^{99m}TcO_4{^-}$.

• Progress in Medical Physics
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• v.24 no.3
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• pp.176-182
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• 2013

Through this research, we measure the data for several SUVs such as SUVLBM, SUVBW, and SUVBSA using volume of interest in order to enhance the diagnostic level in whole-body image for healthy examinees via F-18 FDG PET/CT. Maximum value, mean value, standard deviation, and threshold value for each SUVs are shown. The measurement of SUVs are carried out with 31 examinees who have taken whole-body examination with F-18 FDG PET/CT from July, 2012 to August, 2012. To secure the preciseness of measurement, we selected 26 healthy examinees as a subject of measurement according to diagnostic view of a nuclear-medical doctor. We see from the measurement of SUVs of PET/CT that the value of SUVBW is hightest and followed by SUVLBM and SUVBSA in turn regardless of the use of contrast media. By comparing the SUVLBM-maximum data for the group used contrast media with those for the group used no contrast media, there found a trend that the measured values increase when the contrast media are used. Among them, liver, aorta, lumbar-5, and Cerebellum exhibit significant difference (p<0.05). We conclude that our data for SUVs would be basic references in overall image interpretation, and hope that the research using VOI would be active.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.35 no.4
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• pp.213-220
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• 2009

Purpose: The present study was aimed to examine the usefulness of 18F-FDG PET/CT in the evaluation of cervical lymph node metastasis in patients with oral cancer. Materials and methods: Twenty-two patients who underwent neck dissection to treat oral cancer were subjected for examination. The cervical node metastasis was evaluated by means of clinical examination, CT scan, PET, and histologic examination. By comparing the results of each examination modality with those of histologic examination, it's sensitivity, specificity, positive predictive value, and negative predictive value were determined. Results: The oral cancer was more frequent in males with a ratio of 2.14:1. The sixth decade showed the highest incidence in age distribution with mean of $56{\pm}16$. Histologic findings showed that squamous cell carcinoma was the most common (15 patients), and mucoepidermoid carcinoma (3), malignant melanoma (2), and adenoid cystic carcinoma and ghost cell odontogenic carcinoma (1 each), in order. In most cases, wide surgical excision of the primary cancer and neck dissection was performed, followed by reconstruction with free flaps when necessary. When comparing the results of each examination modality with those of the histologic examination, clinical examination showed sensitivity, specificity, positive predictive value, and negative predictive value at 11%, 85%, 33%, and 58%, respectively. CT scans showed at 67%, 77%, 67%, and 77%, while $^{18}F$-FDG PET/CT at 78%, 77%, 70%, and 83%, respectively. Conclusions: These results suggest that PET is more useful, compared with clinical examination and CT scans, in the evaluation of cervical lymph node metastasis in patients with oral cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.1
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• pp.387-391
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• 2015

Background: Fluorine-18 deoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) and bone scintigraphy (BS) are widely used for the detection of bone involvement. The optimal imaging modality for the detection of bone metastases in hormone receptor positive (+) and negative (-) groups of breast cancer remains ambiguous. Materials and Methods: Sixty-two patients with breast cancer, who had undergone both 18F-FDG-PET/CT and BS, being eventually diagnosed as having bone metastases, were enrolled in this study. Results: 18F-FDG-PET/CT had higher sensitivity and specificity than BS. Our data showed that 18F-FDGPET/CT had a sensitivity of 93.4% and a specificity of 99.4%, whiel for BS they were 84.5%, and 89.6% in the diagnosis of bone metastases. ${\kappa}$ statistics were calculated for 18F-FDGPET/CT and BS. The ${\kappa}$-value was 0.65 between 18F-FDG-PET/CT and BS in all patients. On the other hand, the ${\kappa}$-values were 0.70 in the hormone receptor (+) group, and 0.51 in hormone receptor (-) group. The ${\kappa}$-values suggested excellent agreement between all patient and hormone receptor (+) groups, while the ${\kappa}$-values suggested good agreement in the hormone receptor (-) group. Conclusions: The sensitivity and specificity for 18F-FDG-PET/CT were higher than BS in the screening of metastatic bone lesions in all patients. Similarly 18F-FDG-PET/CT had higher sensitivity and specificity in hormone receptor (+) and (-) groups.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.81-81
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• 2008

A 69-year old male with cholangiocellular carcinoma (CCC) was assigned to our department for whole body PET/CT scan. $^{18}F$-FDG PET/CT images showed an intense hypermetabolic lobulating mass(SUVmax = 8.7 / size : 11.4 mm) in the right hepatic lobe with multiple metastatic lung nodules. We made three dimensional volume rendering fusion images by using advantage workstation 4.3 (GE health care) which provide quick anatomic overview and improve the planning process significantly.

• Journal of Gastric Cancer
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• v.17 no.4
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• pp.384-393
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• 2017

Purpose: The tumor microenvironment is known to be associated with the metabolic activity of cancer cells and local immune reactions. We hypothesized that glucose metabolism measured by 2-deoxy-2-($^{18}F$)fluoro-D-glucose ($^{18}F-FDG$) positron emission tomography (PET)-computed tomography (CT) ($^{18}F-FDG$ PET-CT) would be associated with local immune responses evaluated according to the presence of tumor infiltrating lymphocytes (TILs). Materials and Methods: We retrospectively reviewed 56 patients who underwent $^{18}F-FDG$ PET-CT prior to gastrectomy. In resected tumor specimens, TIL subsets, including cluster of differentiation (CD) 3, CD4, CD8, Forkhead box P3 (Foxp3), and granzyme B, were subjected to immunohistochemical analysis. The prognostic nutritional index (PNI) was calculated as: ($10{\times}serum$ albumin value)+($0.005{\times}peripheral$ lymphocyte counts). Additionally, the maximum standard uptake value ($SUV_{max}$) was calculated to evaluate the metabolic activity of cancer cells. Results: The $SUV_{max}$ was positively correlated with larger tumor size (R=0.293; P=0.029) and negatively correlated with PNI (R=-0.407; P=0.002). A higher $SUV_{max}$ showed a marginal association with higher CD3 (+) T lymphocyte counts (R=0.227; P=0.092) and a significant association with higher Foxp3 (+) T lymphocyte counts (R=0.431; P=0.009). No other clinicopathological characteristics were associated with $SUV_{max}$ or TILs. Survival analysis, however, indicated that neither $SUV_{max}$ nor Foxp3 held prognostic significance. Conclusions: FDG uptake on PET-CT could be associated with TILs, especially regulatory T cells, in gastric cancer. This finding may suggest that PET-CT could be of use as a non-invasive tool for monitoring the tumor microenvironment in patients with gastric cancer.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.43-47
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• 2009

Purpose: The menstrual cycle of normal premenopausal patients was divide into menstrual flow phase, proliferative phase, ovulatory phase, secretory phase. The aim of this study was to ovarian and endometrial $^{18}F$-FDG uptake during the menstrual cycle in normal premenopausal patients. Materials and Methods: We identified 200 incidental $^{18}F$-FDG uptake in the ovary. The patient fasted at least 6 hours before receiving an intravenous injection of 370-592 MBq (10-16mCi) of $^{18}F$-FDG. Scanning from the base of the skull though the mid thigh was performed using the Discovery Ste PET/CT system (GE Healthcare, Milwaukee, WI, USA). Ovarian and endometrial $^{18}F$-FDG uptake (expressed as standardized uptake value) was measured on PET/CT image. Results: Two peaks of increased endometrial $^{18}F$-FDG uptake were identified during the menstrual cycle. The $SUV_{avg}$ and $SUV_{max}$ was $2.89{\pm}1.04$ and $3.17{\pm}1.59$ in menstruating patients, $2.4{\pm}0.88$ and $2.98{\pm}1.14$ in proliferative phase patients, $3.59{\pm}1.76$ and $3.17{\pm}1.67$ in ovulatory phase patients, $2.58{\pm}1.39$ and $3.1{\pm}1.8$ in secretory phase patients. Conclusions: Increased ovarian and endometrial $^{18}F$-FDG uptake could be found the time of menstrual flow and ovulatory phase of menstrual cycle. Increased uptake in endometrial adjacent to a cervical tumor does not necessarily reflect endometrial tumor invasion. Since increased uptake was dependent on the menstrual cycle, it can be avoided by scheduling PET/CT just after menstruation. Non-menstrual-related endometrial uptake may be instrumental in establishing a diagnosis in a premenopaual patient.

• Korean Journal of Radiology
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• v.21 no.7
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• pp.829-837
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• 2020

Objective: The aim of this study was to investigate the prognostic value of the maximum standardized uptake value (SUV_max) measured while restaging with F-18 fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) to predict the 3-year post-recurrence survival (PRS) in patients with recurrent gastric cancer after curative surgical resection. Materials and Methods: In total, 47 patients with recurrent gastric cancer after curative resection who underwent restaging with ¹⁸F-FDG PET/CT were included. For the semiquantitative analysis, SUV_max was measured over the visually discernable ¹⁸F-FDG-avid recurrent lesions. Cox proportional-hazards regression models were used to predict the 3-year PRS. Differences in 3-year PRS were assessed with the Kaplan-Meier analysis. Results: Thirty-nine of the 47 patients (83%) expired within 3 years after recurrence in the median follow-up period of 30.3 months. In the multivariate analysis, SUV_max (p = 0.012), weight loss (p = 0.025), and neutrophil count (p = 0.006) were significant prognostic factors for 3-year PRS. The Kaplan-Meier curves demonstrated significantly poor 3-year PRS in patients with SUV_max > 5.1 than in those with SUV_max ≤ 5.1 (3-year PRS rate, 3.5% vs. 38.9%, p < 0.001). Conclusion: High SUV_max on restaging with ¹⁸F-FDG PET/CT is a poor prognostic factor for 3-year PRS. It may strengthen the role of ¹⁸F-FDG PET/CT in further stratifying the prognosis of recurrent gastric cancer.