• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.70-73
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• 2008

A 65 year-old man with hepatocellulcar carcinoma (HCC) admitted to treat left lower leg swelling and pus discharge suspecting osteomyelitis. MRI of his lower leg revealed the bone metastasis. Whole body FDG PET/CT additionally detected left shoulder and right ilium metastasis. Hematemesis suddenly developed in this patient after 3 weeks. Metastasis of right tonsil was histologically proven. When we reviewed his FDG PET/CT, there was asymmetric mild hypermetabolism in the right tonsil. When focal hypermetabolism is shown in the organ physiologically taking glucose up such as tonsil, we should cautiously assess whole body PET/CT in the examination of distant metastasis. We present a patient with multiple distant metastasis including tonsil from HCC showing increased FDG uptake with the literature review.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.39-43
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• 2008

Purpose: We evaluated whether it was necessary to perform whole body acquisition of $^{18}F$-FDG PET/CT including whole skull and lower extremity (LE) distal to mid-thigh (MT) in patients with multiple myeloma (MM). Materials and Methods: Thirty patients underwent 45 whole body $^{18}F$-FDG PET/CT scans including skull and LE distal to MT. PET scans were divided by 2 subgroups according to the presence of abnormal focal $^{18}F$-FDG uptake in skull or LE distal to MT. Clinical characteristics including age, sex, and stages were compared between the 2 subgroups. Results: Of total 45 whole body PET/CT scans, focally increased abnormal FDG uptake in the skull or LE distal to MT suggesting myeloma involvement was found in 22 scans (48.9%) of 14 patients (46.7%). Skull lesions were more frequently observed than LE lesions distal to MT on PET (86.4% vs. 40.9%, p<0.005). There were no significant differences in age, sex, initial Durie/Salmon stage, and tumor burden at the time of PET scan suggested by serum hemoglobin level, serum calcium level, serum and urine paraprotein level, and serum creatinine level between the two subgroups. The presence of the skull or LE distal MT lesions on PET did not affect on the Durie/Salmon plus stage except only 1 case (1/22, 4.5%, p>0.05). Conclusion: Abnormal lesions in the skull or LE distal to MT on $^{18}F$-FDG PET/CT did not affect significantly on the tumor burden and Durie/Salmon plus stage of MM. Therefore, torso PET acquisition including head may be sufficient for evaluating patients with MM.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.137-139
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• 2008

Wilms Tumor is a great therapeutic success story within pediatric oncology. Therefore, accurate initial staging is needed to assess tumor spread and to assign patients appropriately to the different risk branches. However, it is recognized that FDG-PET can provide useful information about tumor and has better accuracy than CT and MRI for staging, but its role in Wilms tumor is unclear. According to clinical research data, FDG PET may be useful for the management of selected patients with Wilms tumors.

• 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 $^{99m}TcO_4{^-}$.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.1
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• pp.74-76
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• 2008

• 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.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.4
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• pp.335-336
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• 2007

Meniscus-like presentation of ulcerating gastric carcinoma on upper gastrointestinal series radiograph was first described in 1921 by Carman and has since been known as a useful differential diagnostic sign in radiology. In 1982 using then newly introduced computed tomography (CT) Widder and Mueller revisited the meniscus sign. Their study was primarily focused on a dynamic assessment of the demonstrability of the meniscus sign that largely depends on the judgment and technical skill of examiner, especially graded compression and patient positioning. One year earlier Balfe et al. assessed the diagnostic reliability of gastric wall thickening as observed on CT scan in adenocarcinoma, lymphoma and leiomyosarcoma and concluded that it is not a reliable finding. In contrast, however, Lee et al. recently emphasized that the wall thickness measurement on CT of exophytic carcinoma, myoma and ulcers was a useful diagnostic means. Thus, it appears that gastric wall thickening or mucosal heave-up is by itself not as reliable as the meniscus sign. The electronic search of world literature failed to disclose earlier report of this sign demonstrated by $^{18}F-FDG$ positron emission tomography and computed tomography (PET/CT). The present communication documents $^{18}F-FDG$ PET/CT finding of the meniscus sign as encountered in a case of ulcerating gastric carcinoma, the histological diagnosis of which was moderately differentiated tubular adenocarcinoma. Unlike most gastric tumors without ulceration that tend to unimpressively accumulate $^{18}F-FDG$ the present case of Borrmann type III gastric carcinoma demonstrated markedly increased $^{18}F-FDG$ uptake.

• The Korean Journal of Nuclear Medicine
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• v.36 no.6
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• pp.368-380
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• 2002

Purpose: Liver transplantation (LT), one of the therapeutic options of primary liver cancer has been suffering from recurrence caused by metastasis in 8-54% of patients. This study was performed to investigate whether FDG-PET is useful for detecting hidden metastasis in LT candidates. Materials and Methods: Twenty-six patients (male:female=23:3, mean age 55.7 years) underwent FDG-PET. Their previous conventional diagnostic studies (CDS) like abdomen US and CT, chest x-ray and CT, and bone scan were negative (n=22) or equivocal (n=4) for metastasis. Positive FDG-PET findings were confirmed by biopsy or clinical follow-up. Results: Among 4 patients with equivocal metastatic lesions on CDS, 3 had 6 hypermetabolic lesions on FDG-PET, which were confirmed as metastasis and subsequently LTs were cancelled. Of these, 5 lesions were initially negative on CDS. Remained 1 patient underwent LT with a negative FDG-PET result. Among 22 patients without metastasis on CDS, 5 had 7 hypermetabolic lesions on FDG-PET. One of these patients proved to have 2 metastatic lesions, and LT was cancelled. The other 4 patients had S hypermetabolic lesions on FDG-PET, which were confirmed as benign lesions, and 3 patients of them underwent LT. In summary, FDG-PET was useful in avoiding 4 unwarranted LT by detecting unsuspected metastatic lesions on CDS. A total of 17 patients underwent LT. In comparison with pathology, the sensitivity and specificity of FDG-PET for detecting viable primary liver cancer were 55.6% (5/9) and 87.5% (7/8), respectively. Conclusion: FDG-PET can detect additional hidden metastasis and contribute to reducing unwarranted LT in the patients with primary liver cancer.

• Progress in Medical Physics
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• v.20 no.3
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• pp.159-166
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• 2009

Obviously, the administration of the prescribed amount of activity to the patient requires proper operation of the dose calibrator, which shall be verified by implementing the required quality control on the instrument. This investigation examined the accuracy and precision of dose calibrator activity measurement of the radiopharmaceutical F-18 FDG. To investigate the status of the nuclear medicine centers in Korea for the performance of dose calibrators, 10 centers providing PET/CT system services in Korea were inspected in 2008. We measured accuracy and precision in 10 equipments in consideration of PET/CT model, installation area, and installation time. According to the results of comparative analysis of 10 dose calibrators used to measure radioactivity of F-18 FDG, accuracy was -5.00~4.50% and precision was 0.05~0.45%, satisfying the international standards, which are accuracy ${\pm}$10% and precision ${\pm}$5%. This study demonstrated that, for accurate measurements, no adjustment is necessary for a dose calibrator setting when measuring different dose calibrators of F-18 FDG activity prescriptions.

• Journal of the Korean Society of Radiology
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• v.12 no.2
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• pp.159-165
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• 2018

The purpose of this study is to provide the basic information for diagnosis and treatment of fatty liver by investigating the relationship of the body $^{18}FDG$ uptake and CT Number in patients with fatty liver. This study was conducted on patients who were admitted to the N hospital from January 2014 to October 2015 underwent PET-CT. This result, the probability of fatty liver was 5 times higher in male. The $^{18}FDG$ uptaking were increased by more than 1.000 times respectively in the Liver RT, Middle liver, Liver LT from patients with fatty liver (p <.05). And the CT Number were decreased by 0.93, 0.88, and 0.92 times respectively in Liver RT, Middle liver, Liver LT from patients with fatty liver (p <.05). In conclusion, significant changes of $^{18}FDG$ uptake rate and CT number according to fatty liver provide reliable information for diagnosis and treatment of fatty liver patients. And it can be used as a basic data for the study of fatty liver predictability.