• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.19-25
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• 2009

Purpose: The aims of this study were to analyze correlation between the maximum standardized uptake value (SUVmax) of 2-[F-18]-fluoro-2-deoxy-d-glucose (FDG) on positron emission computed tomography (PET-CT) scan and the degree of contrast enhancement on computed tomography (CT) scan in lung cancers, and to recognize the difference in SUVmax and CT enhancement between groups of different histopathologic subtypes. Materials and Methods: Our study included 53 patients of pathologically confirmed primary lung cancer, who were performed PET-CT and post-contrast chest CT. We calculated initial and delayed SUVmax (SUV1, SUV2), difference between SUV1 and SUV2 (SUVd), retention index (RI), and the degrees of CT contrast enhancement of lung cancers. We analyzed these variables for subtypes of lung cancers. Results: The values (mean$\pm$ standard deviation) were $8.3{\pm}4.4$ for SUV1, $10.7{\pm}5.7$ for SUV2, $2.4{\pm}1.6$ for SUVd, $30{\pm}14$ for RI and $47.1{\pm}14.8$ HU (Hounsfield Unit) for degree of CT contrast enhancement. The difference of SUV1 and degree of CT enhancement between subtypes was not meaningful. SUV1 showed positive correlations with SUVd (r=0.74, p<0,01) and tumor size (r=0.58, p<0.01), but no significant correlation with degree of CT enhancement (r=0.06, p=0.69). In 10 cases, there was discrepancy in the same mass between the area of highest FDG-uptake and the area of highest contrast enhancement. Conclusion: We suggest that FDG uptake in lung cancer does not have a positive linear correlation with degree of CT enhancement. And there is no significant difference in FDG uptake and degree of CT enhancement between different subtypes of lung cancers.

• IEMEK Journal of Embedded Systems and Applications
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• v.18 no.6
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• pp.267-275
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• 2023

This paper presents the development of specialized software for annotating volume-of-interest on ¹⁸F-FDG PET/CT images with the goal of facilitating the studies and diagnosis of head and neck cancer (HNC). To achieve an efficient annotation process, we employed the SE-Norm-Residual Layer-based U-Net model. This model exhibited outstanding proficiency to segment cancerous regions within ¹⁸F-FDG PET/CT scans of HNC cases. Manual annotation function was also integrated, allowing researchers and clinicians to validate and refine annotations based on dataset characteristics. Workspace has a display with fusion of both PET and CT images, providing enhance user convenience through simultaneous visualization. The performance of deeplearning model was validated using a Hecktor 2021 dataset, and subsequently developed semi-automatic annotation functionalities. We began by performing image preprocessing including resampling, normalization, and co-registration, followed by an evaluation of the deep learning model performance. This model was integrated into the software, serving as an initial automatic segmentation step. Users can manually refine pre-segmented regions to correct false positives and false negatives. Annotation images are subsequently saved along with their corresponding ¹⁸F-FDG PET/CT fusion images, enabling their application across various domains. In this study, we developed a semi-automatic annotation software designed for efficiently generating annotated lesion images, with applications in HNC research and diagnosis. The findings indicated that this software surpasses conventional tools, particularly in the context of HNC-specific annotation with ¹⁸F-FDG PET/CT data. Consequently, developed software offers a robust solution for producing annotated datasets, driving advances in the studies and diagnosis of HNC.

• The Korean journal of internal medicine
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• v.39 no.2
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• pp.327-337
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• 2024

Background/Aims: The prognostic significance of ¹⁸F-fluorodeoxyglucose (FDG)-positron emission tomography-computed tomography (PET/CT) in peripheral T-cell lymphomas (PTCLs) are controversial. We explored the prognostic impact of sequential ¹⁸F-FDG PET/CT during frontline chemotherapy of patients with PTCLs. Methods: In total, 143 patients with newly diagnosed PTCLs were included. Sequential ¹⁸F-FDG PET/CTs were performed at the time of diagnosis, during chemotherapy, and at the end of chemotherapy. The baseline total metabolic tumor volume (TMTV) was calculated using the the standard uptake value with a threshold method of 2.5. Results: A baseline TMTV of 457.0 cm³ was used to categorize patients into high and low TMTV groups. Patients with a high TMTV had shorter progression-free survival (PFS) and overall survival (OS) than those with a low TMTV (PFS, 9.8 vs. 26.5 mo, p = 0.043; OS, 18.9 vs. 71.2 mo, p = 0.004). The interim ¹⁸F-FDG PET/CT response score was recorded as 1, 2-3, and 4-5 according to the Deauville criteria. The PFS and OS showed significant differences according to the interim ¹⁸F-FDG PET/CT response score (PFS, 120.7 vs. 34.1 vs. 5.1 mo, p < 0.001; OS, not reached vs. 61.1 mo vs. 12.1 mo, p < 0.001). Conclusions: The interim PET/CT response based on visual assessment predicts disease progression and survival outcome in PTCLs. A high baseline TMTV is associated with a poor response to anthracycline-based chemotherapy in PTCLs. However, TMTV was not an independent predictor for PFS in the multivariate analysis.

• Journal of the Korea Safety Management & Science
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• v.15 no.4
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• pp.427-433
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• 2013

Recently, 18F-FDG PET based CT scan was a critical examination that the after, before plan diagnosis and treatment of tumors. But, due to the distortion of SUV that should be proportional to the metabolic rate of glucose in the tumor, the other measurement methods are being on study. In this study, compared the degree of distortion of SUV that according to the volume of the tumor analysis ROI and VOI using the NEMA IEC Phantom. The results, the SUVmax, mean value are rapidly decreased with threshold value 500 mm2 interval of the ROI analysis, 1500 mm3 interval of the VOI analysis. When compared SUVmax value SUVmean, ROI and VOI analysis VOI measurements was 1.077 times higher SUVmax was 0.981 times highe compared to the value of the ROI measurement. Compare MTV, SUV 2.0 as measured by the volume of the VOI to Volume showed a slightly higher results(Volume / MTV = $93.4 %{\pm}14.8 %$). Considering the above results, Tumor evaluation by 18F-FDG PET / CT scan Consider each threshold value should be analyzed due to larger SUV's Distortion depending on the size of the tumor. VOI analysis is recommended. because it showed the VOI analysis is higher than the ROI analysis SUVmax and lower SUVmean due to VOI analysis than once as a measure of the wider area as measured ROI analysis. MTV (R2 = 0.999), a result close to the actual size of the tumor. but, more research is needed in this regard, because SUV according to the standards of value are affected.

• Korean Journal of Head & Neck Oncology
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• v.28 no.2
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• pp.118-121
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• 2012

Backgrounds : To evaluated the use of FDG PET/CT for the identification of extracapsular spread(ECS) with histologic correlation in laryngeal cancer. Methods : We reviewed 79 medical records of patients who underwent of FDG PET/CT for laryngeal cancer before surgery. Results : ECS was present in 41.9%(18/43) dissected necks and in 34.5%(20/58) dissected cervical levels. There was a significant difference in the SUVmax between cervical lymph nodes with ECS and without ECS($6.39{\pm}4.53$ vs. $1.19{\pm}1.64$, p<0.001). The cut-off value for the SUVmax for differentiating with ECS from without ECS was 2.8 with the sensitivity of 85.7% and the specificity of 85.6%. Conclusion : The median SUVmax cut-off values of FDG PET/CT higher than 2.8 was associated with greater risk cervical lymph node metastasis with ECS in patients with laryngeal cancer.

• Radiation Oncology Journal
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• v.36 no.2
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• pp.95-102
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• 2018

Purpose: To evaluate the prognostic value of $^{18}F$-fluorodeoxyglucose positron-emission tomography (FDG PET) with computed tomography (CT) before and during radiotherapy (RT) in patients with head and neck cancer. Methods: Twenty patients with primary head and neck squamous cell carcinoma were enrolled in this study, of whom 6 had oropharyngeal cancer, 10 had hypopharyngeal cancer, and 4 had laryngeal cancer. Fifteen patients received concurrent cisplatin and 2 received concurrent cetuximab chemotherapy. FDG PET/CT was performed before RT and in the 4th week of RT. The parameters of maximum standardized uptake value, metabolic tumor volume, and total lesion glycolysis (TLG) of the primary tumor were measured, and the prognostic significance of each was analyzed with the Cox proportional hazards model. Results: Higher TLG (>19.0) on FDG PET/CT during RT was a poor prognostic factor for overall survival (OS) (p = 0.001) and progression-free survival (PFS) (p = 0.007). In the multivariate analysis, TLG during RT as a continuous variable was significantly associated with OS and PFS rate (p = 0.023 and p = 0.016, respectively). Tumor response worse than partial remission at 1 month after RT was another independent prognostic factor for PFS (p = 0.024). Conclusions: Higher TLG of the primary tumor on FDG PET/CT during RT was a poor prognostic factor for OS and PFS in patients with head and neck cancer.

• The Journal of the Korean bone and joint tumor society
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• v.18 no.1
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• pp.45-49
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• 2012

Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.

• Journal of radiological science and technology
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• v.38 no.1
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• pp.31-38
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• 2015

$^{18}F-FDG$ PET/CT has been known a useful modality to diagnose high-glucose-using cells such as cancer cells by glucose metabolism of FDG. Mainly, FDG takes on cancer and inflammatory cells; however, there have been FDG uptakes on normal tissues by individual physiological characteristics, occasionally. Especially, in fertile females, unusual FDG uptake of breast changes as the menstrual cycle, and disturb diagnosis. Therefore, the study aimed to evaluate the change of breast FDG uptake in menstrual cycle on $^{18}F-FDG$ PET/CT. 160 females ($34{\pm}3.5$ years old) who do not undergo a gynecologic anamnesis and have regular menstrual cycle over the previous 6 months were examined. They were divided 4 groups (each 40 patients) as flow phase, proliferative phase, ovulatory phase and secretory phase using Pregnancy Calculator 0.14. and history taking. Discovery Ste (GE Healthcare, Milwaukee, Mi, USA) was used a s PET/CT. We analyzed SUVs on accumulated region on breast, and 3 nuclear medicine specialists did the Blind test. SUVs on the Breast were flow phase ($1.64{\pm}0.25$), proliferative phase ($0.93{\pm}0.28$), ovulatory phase ($1.66{\pm}0.26$) and secretory phase ($1.77{\pm}0.28$). It showed high uptake value in secretory, flow phase and ovulatory phase (p<0.05). In gross analysis, the accumulation of breast was divided into 3 grades as comparing with lung and liver. The breast's uptake was equal to lung (Grade I); between lung and liver (Grade II); equal to or greater than liver (Grade III). The results showed high uptake value in secretory, flow phase and ovulatory phase (p<0.05). In fertile females, FDG uptake of breast changed as menstrual cycle, and it available to diagnose breast disease. Therefore, we consider reducing false-negative finding of breast disease, by doing examination on appropriate period through history taking about individual menstrual cycle.

• The Korean Journal of Nuclear Medicine Technology
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• v.15 no.1
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• pp.39-44
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• 2011

Purpose: $^{18}F$-FDG PET/CT has been known a useful modality to diagnose high-glucose-using cells such as cancer cells by glucose metabolism of FDG. Mainly, FDG takes on cancer and inflammatory cells; However, There have been FDG uptakes on normal tissues by individual physiological characteristics, occasionally. Especially, in fertile females, unusual FDG uptake of breast changes as the menstrual cycle, and disturb diagnosis. Therefore, the study aimed to evaluate the change of breast FDG uptake in menstrual cycle on $^{18}F$-FDG PET/CT. Materials and Methods: 160 females ($34{\pm}3.5$ years old) who do not undergo a gynecologic anamnesis and have regular menstrual cycle over the previous 6 months were examined, from March 2009 to February 2010. They were divided 4 groups (each 40 patients) as flow phase, proliferative phase, ovulatory phase and secretory phase using Pregnancy Calculator 0.14. and history taking. Discovery Ste (GE Healthcare, Milwaukee, Mi, USA) was used as PET/CT. We analyzed SUVs on accumulated region on breast, and 3 nuclear medicine specialists did the Blind test. Results: SUVs on the Breast were flow phase ($1.64{\pm}0.25$), proliferative phase ($0.93{\pm}0.28$), ovulatory phase ($1.66{\pm}0.26$) and secretory phase ($1.77{\pm}0.28$). It showed high uptake value in secretory, flow phase and ovulatory phase (p<0.05). In gross analysis, the accumulation of breast was divided into 3 grades as comparing with lung and liver. The breast's uptake was equal to lung (Grade I); between lung and liver (Grade II); equal to or greater than liver (Grade III). The results showed high uptake value in secretory, flow phase and ovulatory phase (p<0.05). Conclusion: In fertile females, FDG uptake of breast changed as menstrual cycle, and it available to diagnose breast disease. Therefore, we consider reducing false-negative finding of breast disease, by doing examination on appropriate period through history taking about individual menstrual cycle.

• Radiation Oncology Journal
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• v.27 no.3
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• pp.111-119
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• 2009

Purpose: This study aimed at assessing the value of fluorine-18 fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET) for predicting the response of locally advanced rectal cancer to neoadjuvant CRT. Materials and Methods: Between August 2006 and January 2008, we prospectively enrolled 20 patients with locally advanced rectal cancer and who were treated with neoadjuvant CRT at the Korea Institute of Radiological and Medical Sciences. The treatment consisted of radiation therapy and chemotherapy, and this was followed by curative resection 6 weeks later. All the patients underwent $^{18}F$-FDG PET/CT both before CRT and 6 weeks after completing CRT. The measurements of the FDG uptake ($SUV_{max}$), the absolute difference (${\Delta}SUV_{max}$) and the percent $SUV_{max}$ difference (response index, $RI_{SUV}$) between the pre- and post-CRT $^{18}F$-FDG PET/CT scans were assessed. The measurements of the metabolic volume, the absolute difference (${\Delta}$metabolic volume) and the percent metabolic volume difference (response index, $RI_{metabolic\;volume}$) were also assessed. Results: Of the 20 patients who underwent surgery, 11 patients (55%) were classified as responders according to Dworak's classification. The post-CRT $SUV_{max}$ was significantly lower than the pre-CRT $SUV_{max}$. However, there were no significant differences in the $SUV_{max}$ and the metabolic volume reduction between the responders and non-responders. We used a minimum $SUV_{max}$ reduction of 67% as the cut-off value for defining a response, with a sensitivity of 45.5%, a specificity of 88.9%, a positive predictive value of 77% and a negative predictive value of 53.8%. Conclusion: Although there were no statistically significant results in this study, other studies have revealed that $^{18}F$-FDG PET/CT has the potential to assess the tumor response to neoadjuvant CRT in patients with locally advanced rectal cancer.