• Title/Summary/Keyword: Lymphoma, CT

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Stereotactic Radiosurgery for Intracranial Tumors; Early Experience with Linear Accelerator (두개강내 종양에 대한 방사선 뇌수술의 역할)

  • Suh Chang Ok;Chung Sang Sup;Chu Sung Sil;Kim Young Soo;Yoon Do Heum;Kim Sun Ho;Loh John Juhn Kyu;Kim Gwi Eon
    • Radiation Oncology Journal
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    • v.10 no.1
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    • pp.7-14
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    • 1992
  • Between August 1988 and December 1991, 24 patients with intracranial tumors were treated with stereotactic radiosurgery(RS) using a 10 MV linear accelerator at Severance Hospital, Yonsei University College of Medicine. There were 5 meningiomas, 3 craniopharyngiomas, 9 glial tumors, 2 solitary metastases, 2 acoustic neurinomas, 2 pineal tumors, and 1 non-Hodgkin's lymphoma. Ten patients were treated as primary treatment after diagnosis with stereotactic biopsy or neuroimaging study. Nine patients underwent RS for post-op. residual tumors and three patients as a salvage treatment for recurrence after external irradiation. Two patients received RS as a boost followed by fractionated conventional radiotherapy. Among sixteen patients who were followed more than 6 months with neuroimage, seven patients (2 meningiomas, 4 benign glial tumors, one non-Hodgkin's lymphoma) showed complete response on neuroimage after RS and nine patients showed decreased tumor size. There was no acute treatment related side reaction. Late complications include three patients with symptomatic peritumoral brain edema and one craniopharyngioma with optic chiasmal injury. Through this early experience, we conclude that stereotactically directed single high doses of irradiation to the small intracranial tumors is effective for tumor control. However, in order to define the role of radiosurgery in the management of intracraniai tumors, we should get the long-term results available to demonstrate the benefits versus potential complications of this therapeutic modality.

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Analysis of Mediatinal Lymph Nodes with Internal Low Density on Contrast Enhanced CT Scan (조영종강 전산화단층촬영상 내부 저밀도 음영을 보이는 종격동 림프절의 분석)

  • Ryu, Young-Hoon;Choe, Kyu-Ok;Hong, Yong-Kook;Kim, Sung-Kyu;Chang, Joon;Lee, Won-Young
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.2
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    • pp.264-279
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    • 1997
  • Background : To analyze the morphologic characteristics of low density lymph node in etiologic differentiation of lymphadenopathy, emphasizing the different features between tuberculosis and lung cancer, on contrast enhanced CT scan. Method : A total of 64 patients who showed low density lymph nodes on chest CT scan were analyzed. Primary causes were tuberculosis (n=28), lung cancer (n=27), malignant lymphoma (n=5) and metastasis from extrathoracic malignancies (n=4). CT scan was performed with 10mm slice thickness and 7 characteristic features were evaluated : location, size, presence or absence of the nonnecrotic lymph node, calcification, perinodal fat obliteration, thickness and evenness of the enhancing rim. Results : In patients with tuberculous lymphadenopathy, lymph nodes with uneven (68.0%) and thick (62.1%) enhancing rim were more common than lung cancer (p<0.05). Low density lymph nodes with less than 1 cm in size were found only in tuberculous lymphadenopathy(n=10). In 48.2% of patients with lung cancer, more than 1 nonnecrotic enlarged lymph node were coexisted, whereas 21.4% in patients with tuberculous lymphadenopathy(p=0.06). However, the size, location and calcification were not statistically significant between tuberculous lymphadenopathy and lung cancer. Conclusion : Tuberculous lymphadenopathy is strongly suggested when enhancing rim of enlarged lymph nodes is uneven and thick, when the coexisting nonnecrotic lymph nodes are few in number and when central low density is encountered in normal sized lymph nodes.

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Preoperative Evaluation of Brain Lesion with $^{201}Tl$ Brain SPECT: Is It Useful to Differentiate Benign and Malignant Lesions? (수술 전 뇌 병변의 $^{201}Tl$ 뇌 SPECT: 양성과 악성 병변을 감별하는데 유용한가?)

  • Sohn, Hyung-Sun;Kim, Euy-Neyng;Kim, Sung-Hoon;Chung, Yong-An;Chung, Soo-Kyo;Bong, Yong-Gil;Lee, Youn-Soo
    • The Korean Journal of Nuclear Medicine
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    • v.34 no.5
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    • pp.371-380
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    • 2000
  • Purpose: Thallim-201 ($^{201}Tl$) brain SPECT, which can represent cellular activity of brain lesions, may provide more useful information in differentiating between benign and malignant brain lesions more so than CT of MRI, that merely represents anatomic changes or breakdown of blood brain barrier. We used $^{201}Tl$ brain SPECT prospectively to evaluate the utility of $^{201}Tl$-indices as an indicator of benign or malig nant lesions. Materials and Methods: We studied 28 patients. There were 13 cases of benign lesions (3: nonspecific benign lesion, 3: meningioma, 2: low grade glioma, 1: tuberculoma, central neurocytoma, hemangioblastoma, radiation necrosis, and choroid plexus papilloma) and 15 cases of malignant lesions (6: glioblastoma multiforme, 5: anaplastic glioma, 2: medulloblastoma, 1: metastasis and lymphoma). In all patients, CT and/or MRI were obtained and then $^{201}Tl$ brain SPECT was obtained with measuring mean $^{201}Tl$ index and peak $^{201}Tl$ index. An unpaired t-test was performed to compare the $^{201}Tl$-indices and pathologic diagnoses to evaluate the utility of $^{201}Tl$-indices as all indicator of benign or malignant lesions. Results: There were no statistically significant difference in $^{201}Tl$-indices between benign and malignant brain lesion (p>0.05). Conclusion: These results demonstrated that we could not use $^{201}Tl$ indices on brain SPECT alone as an indicator of benign or malignant brain lesions.

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Current Status and Future Perspective of PET (PET 이용 현황 및 전망)

  • Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.1-7
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    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

Comparison of anticancer activities of Korean Red Ginseng-derived fractions

  • Baek, Kwang-Soo;Yi, Young-Su;Son, Young-Jin;Jeong, Deok;Sung, Nak Yoon;Aravinthan, Adithan;Kim, Jong-Hoon;Cho, Jae Youl
    • Journal of Ginseng Research
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    • v.41 no.3
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    • pp.386-391
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    • 2017
  • Background: Korean Red Ginseng (KRG) is an ethnopharmacological plant that is traditionally used to improve the body's immune functions and ameliorate the symptoms of various diseases. However, the antitumorigenic effects of KRG and its underlying molecular and cellular mechanisms are not fully understood in terms of its individual components. In this study, in vitro and in vivo antitumorigenic activities of KRG were explored in water extract (WE), saponin fraction (SF), and nonsaponin fraction (NSF). Methods: In vitro antitumorigenic activities of WE, SF, and NSF of KRG were investigated in the C6 glioma cell line using cytotoxicity, migration, and proliferation assays. The underlying molecular mechanisms of KRG fractions were determined by examining the signaling cascades of apoptotic cell death by semiquantitative reverse transcriptase polymerase chain reaction and Western blot analysis. The in vivo antitumorigenic activities of WE, SF, and NSF were investigated in a xenograft mouse model. Results: SF induced apoptotic death of C6 glioma cells and suppressed migration and proliferation of C6 glioma cells, whereas WE and NSF neither induced apoptosis nor suppressed migration of C6 glioma cells. SF downregulated the expression of the anti-apoptotic gene B-cell lymphoma-2 (Bcl-2) and upregulated the expression of the pro-apoptotic gene Bcl-2-associated X protein (BAX) in C6 glioma cells but had no effect on the expression of the p53 tumor-suppressor gene. Moreover, SF treatment resulted in activation of caspase-3 as evidenced by increased levels of cleaved caspase-3. Finally, WE, SF, and NSF exhibited in vivo antitumorigenic activities in the xenograft mouse model by suppressing the growth of grafted CT-26 carcinoma cells without decreasing the animal body weight. Conclusion: These results suggest that WE, SF, and NSF of KRG are able to suppress tumor growth via different molecular and cellular mechanisms, including induction of apoptosis and activation of immune cells.

Classification of submitted nuclear medicine dissertation and directional consideration (핵의학 투고 논문 분류 및 방향성 고찰)

  • Ho-Yeon, Cho;Yeong-Ran, Woo;Kang-Rok, Seo;Gun-Chul, Hong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.26 no.2
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    • pp.37-42
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    • 2022
  • Purpose Since 1985, the Korean society of nuclear medicine technology (KSNMT) has been engaged in academic activities related to nuclear medicine imaging. From 2017 to 2021, the papers published in the journal were classified by the specific fields to examine the trends in the research and the direction of nuclear medicine in comparison with the papers submitted to the Korean Society of Nuclear Medicine (KSNM) during the same period. Materials and Methods From 2017 to 2021, papers submitted to KSNMT and KSNM were classified and databaseization using the Excel program by submission type, examination equipment, and examination field. Through this data, the number of papers published in journals by year, the number of papers submitted by detailed fields, and key words by era were analyzed and compared. Results The papers included by journal was 57 KSNMT and 280 KSNM. The major large classification of equipment, PET, Planar and SPECT was 26.3%, 21.1%, 19.3% in the KSNMT, KSNM was 49.6%, 6.4%, and 9.3%, with 66.7% and 65.3%, respectively. the major medium classification of equipment, industrial safety, urogenital system, nervous system, and quality control accounted for 54.4% of the total papers of the total ratio in the KSNMT, while the medium classification of oncology, endocrine system, urogenital system, therapy, and nervous system accounted for 61.1% of KSNM. In the major small classification of image acquisition, improvement effect, and exposure management accounted for 70.2% in KSNMT, while the items of image acquisition, report, and improvement effect accounted for 60.7% in KSNM. The major keywords except for equipment-related keywords such as PET/CT, PET/MR, and SPECT were SUV, Planar Image, and Respiration Gating Method in KSNMT and Ga68, Thyroid, and Lymphoma in the KSNM. Conclusion When checking the last 5 years of submissions, we can see that KSNMT is mainly concerned with image acquisition using existing radiotracers, while KSNM has focused on new radiotracers such as 68Ga, 177Lu, etc., and new medical technologies of theranostic. It has been confirmed that more PET-related papers than other examination equipment will account for a greater number of papers, and it is believed that future submissions will also account for a higher proportion of PET-related papers than other equipment.

Usefulness of the Pleural Fluid Adenosine Deaminase with Lymphocyte/Neutrophil Ratio in the Diagnosis of Tuberculous Pleurisy for a Region of Intermediate Prevalence of Tuberculosis (중등도 결핵 유병률 지역에서 결핵성흉막염 진단에 있어 흉수 아데노신 탈아미노효소와 림프구/호중구 비의 유용성)

  • Kim, Chang Hwan;Mo, Eun Kyung;Park, Sung Hoon;Hwang, Yong Il;Jang, Seung Hun;Park, Yong Bum;Kim, Cheol Hong;Kim, Dong-Gyu;Lee, Myung Goo;Hyun, In Gyu;Jung, Ki-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.6
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    • pp.437-443
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    • 2009
  • Background: The aim of this study was to consider the significance of pleural fluid adenosine deaminase (ADA) activity combined with lymphocyte/neutrophil (L/N) ratio in the diagnosis of tuberculous pleurisy (TBpl) in a region of intermediate prevalence of tuberculosis (TB). Methods: We collected data from 388 patients with exudative pleural effusions. The final diagnoses were compared to the results from our diagnostic method using pleural fluid ADA and L/N ratio. Results: 108 patients had a final diagnosis of TBpl; 102 cases had high levels of ADA ($\geq$40 IU/L). When we considered ADA $\geq$40 IU/L as a diagnostic criterion, the sensitivity was 94.4%, specificity 87.5%, and posttest posttest probability 74.5%. However, when we considered ADA $\geq$40 IU/L combined with the L/N ratio $\geq$0.75 as a diagnostic criterion, the specificity and post-test probability were rose to 97.5% and 93%, respectively. The other causes of high ADA and L/N ratios were lymphoma and metastatic carcinoma, but mass-like lesions were found on the chest radiographs or CT scans. Conclusion: To evaluate the causes of exudative pleural effusions in a region of intermediate prevalence of tuberculosis, we recommend measuring the pleural fluid ADA and L/N ratio first. If the result is high and malignancies are not suspected, it may be diagnostic of TBpl.

Analysis of Exploratory Thoracotomy in Non-Small Cell Lung Cancer (원발성 폐암에서의 시험적 개흉술의 분석)

  • 허재학;성숙환;김영태
    • Journal of Chest Surgery
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    • v.32 no.6
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    • pp.536-542
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    • 1999
  • Background: The purpose of this study is to improve the quality of the diagnostic procedures in the preoperative evaluation so as to reduce the unnecessary thoracotomy and to ensure resectability in non-small cell lung cancer. Material and Method: Of 616 patients who underwent thoracotomy for primary lung cancer from January 1990 to December 1996, 59 patients(9.6%) turned out to have inoperable lesions after the thoracotomy. We reprospectively reviewed the bronchoscopic findings, methods of tissue diagnosis, CT scans, pulmonary function test and lung perfusion scan, reasons for nonresectability, and adjuvant therapy, and then followed up on the survival rate after exploratory thoracotomy. Result: The cell types were squamous cell carcinoma in 38, adenocarcinoma in 15, large cell carcinoma in 3 and others in 3. Primary loci were RUL in 20, RML in 6, RLL in 8, LUL in 13, LLL in 4 and others in 8. The reasons for non-resectability were various; direct tumor invaison to mediastinal structures(n=41), seeding on pleural cavity(n=8), poor pulmonary function(n=2), invasions to extranodal mediastinal lymph node(n=2), technical non- resectability due to extensive chest wall invasion (n=3), small cell carcinoma (n=1), malignant lymphoma(n=1), and multiple rib metastases(n=1). In the follow-up of 58 patients, 1-year survival rate was 55.2% and 2-year survival rate was 17.2% and the mean survival time was 14 months. When compared according to cell types or postoperative adjuvant therapeutic modalities, no significant difference in the survival rates were found. The squamous cell carcinoma was frequently accompanied by local extension to contiguous structures and was the main cause of non-resectability. In adenocarcinoma, pleural seeding with malignant effusion was frequently encountered, and was the major reason for non-resectability. Conclusion: These data revealed that if appropriate preoperative diagnostic tools had been available, many unnecessary thoracotomies could have been avoided. Both the use of thoracoscopy in selected cases of adenocarcinoma and the more aggressive surgical approach to the locally advanced tumor could reduce the incidence of unnecessary thoracotomies for non-small cell lung cancers.

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