• Imaging Science in Dentistry
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• v.36 no.2
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• pp.111-116
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• 2006

PET/CT is a new imaging technology that combines high-quality Positron Emission Tomography (PET) and Computed Tomography (CT). This imaging provides simultaneous anatomical and metabolic information. Therefore PET/CT is useful diagnostic modality for early detection of malignant tumor, accurate staging, decision on therapeutic plan, monitoring response to therapy and rapid detection of recurrence. We report oral and maxillofacial cancers diagnosed by using PET/CT and the usefulness of PET/CT in the evaluation of postoperative recurrence.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.2
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• pp.137-144
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• 2008

Positron emission tomography-computed tomography (PET/CT) provides both functional and anatomical images of high quality non-invasively with better precision in localization than PET alone. Increase in the use of PET/CT, coupled with increasing concerns about the quality of medical services accrued the demands for accurate evaluation of system performance and quality assurance. Thus, well designed programs for performance evaluation and quality assurance are needed. Widely used protocols for performance evaluation of PET are the methods proposed by National Electrical Manufacturers Association (NEMA) in 1994 and 2001. In addition, in order to maintain high quality of PET/CT images, quality assurance programs including periodic (daily, monthly, and yearly). Therefore, in this article, the methods and present state of performance evaluation and quality assurance of PET/CT are reviewed.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.1 no.2
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• pp.130-136
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• 2015

We evaluate the influence of MR contrast agent on positron emission tomography (PET) image using phantom, animal and human studies. Phantom consisted of 15 solutions with the mixture of various concentrations of Gd-based MR contrast agent and fixed activity of [$^{18}F$]FDG. Animal study was performed using rabbit and two kinds of MR contrast agents. After injecting contrast agent, CT or MRI scanning was performed at 1, 2, 5, 10, and 20 minutes. PET image was obtained using clinical PET/CT scan, and attenuation correction was performed using the all CT images. The values of HU, PET activity and MRI intensity were obtained from ROIs in each phantom and organ regions. In clinical study, patients (n=20) with breast cancer underwent sequential acquisitions of early [$^{18}F$]FDG PET/CT, MRI and delayed PET/CT. In phantom study, as the concentration increased, the CT attenuation and PET activity also increased. However, there was no relationship between the PET activity and the concentration in the clinical dose range of contrast agent. In animal study, change of PET activity was not significant at all time point of CT scan both MR contrast agents. There was no significant change of HU between early and delayed CT, except for kidney. Early and delayed SUV in tumor and liver showed significant increase and decrease, respectively (P<0.05). Under the condition of most clinical study (< 0.2 mM), MR contrast agent did not influence on PET image quantitation.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.10-16
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• 2009

Purpose: As the number of patients has increased since the installation of a PET/CT, we are now examining about 2500-3000 annually. We have realized that if we properly adjust a pitch under the same condition of a CT during a PET/CT exam, radiation quantity that reaches the patient can change. In order to reduce the exposure dose of a patient, the research examines a method of reducing the exposure dose of a patient by controlling the pitch during a PET/CT exam, viewing whether the adjustment of the pitch influences CT image and PET SUV. Methods: The equipment used is a Biograph Positron Emission Tomography (PET) Scanner (CT type: TRCT-240-130 (WCT-240-130)) of Siemens company. For the evaluation of exposure dose of a patient, we measured radiation quantities using a PTW-DIADOS 11003/1383, which is a CT radiation measurement instrument used by Siemens. We measured and analyzed the space resolutions of CT images caused by the change of pitches using an AAPM Standard Phantom in order to see how the adjustment of pitches influenced the CT images. In addition, in order to obtain SUVs caused by each change of pitches using a PET source made with a solid radioactive cylinder phantom, we confirmed whether the SUVs changed in the PET/CT images by calculating the SUVs of the fusion images caused by the change of pitches after obtaining CT and PET images and finishing the test. Results: 2slice CT scanner showed that radiation quantities largely dropped when pitches ranged from 0.7 to 1.3 and that the reduction of radiation quantities were smaller when pitches ranged from 1.5 to 1.9. That is, we found that the bigger pitch values are the smaller the radiation quantities of a patient are. Moreover, we realized that there is no change of SUVs caused by the increase of pitches and that pitch values do not influence PET SUVs and the quality of CT images. It is judged that using 1.5 as a pitch value contributes to the reduction of exposure dose of a patient as long as there is no problem in the quality of an image. Conclusions: When seeing the result of the research, hospital using a PET/CT should make an effort to reduce the exposure dose of a patient seeking pitch values appropriate for their hospital within the range in which there is no image distortion and PET SUVs are not influenced from pitches. We think that the research can apply to all multi-detectors having a CT scanner and that such a research will be needed for other equipments in the future.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.130-133
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• 2008

Adrenal tumors are increasingly detected by widespread use of anatomical imaging such as a, MRI, etc. For these adrenal tumors, differentiation between malignancy and benignancy is very important. In diagnostic assessment of adrenal tumor, $^{18}F-FDG$ PET and PET-CT have been reported to have high diagnostic performance, especially, very excellent performance in evaluation of adrenal metastasis in the oncologic patient. In cases of adrenal incidentalomas, $^{18}F-FDG$ PET or PET-CT is helpful if a or chemical-shift MRI is inconclusive. $^{18}F-FDG$ PET and PET-CT may be applied to the patients with MIBG-negative pheochromocytomas. In summary, $^{18}F-FDG$ PET and PET-CT are expected to be effective diagnostic tools in the management of adrenal tumor.

• The Korean Journal of Nuclear Medicine Technology
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• v.12 no.1
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• pp.27-32
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• 2008

Purpose: The evaluation of SUV (Standardized Uptake Values) for quantitative analysis in PET exam is the most significant. In PET exam, we make attenuation correction images by using $^{68}Ge$, $^{137}Cs$ or CT data. At this time, a distorted attenuation map affects quantitative analysis. After the exam using barium-sulfate and high density of barium contrast make attenuation map distorted. And then it brings bed influences on SUV. The aim of this study is to verify the relationship between high density barium-sulfate and SUV in PET exam. Materials and Methods By using $^{18}F$-FDG, we made barium-sulfate powder, density of 0, 1.5, 3, 5, 10 and 15% respectively and acquired PET and PET/CT images per each density. And we examined SUV variations from PET and PET/CT images according to differences of barium's density. Moreover, we finally calculated SUV causing variations in HU (Hounsfield Units) values to justify whether the differences of barium density bring any changes in PET/CT exam. Results: From PET images acquired from transmission scan with $^{68}Ge$, we got SUV figures from 6.46 to 6.8 in barium density between 0 to 15 percent. On the other hand, In PET images acquired from Tx scan that using CT, SUV was 6.77 to 23.73, derived from the same barium density. And CT HU values range from 29 to 2004. Conclusion: PET images from Tx data using $^{68}Ge$ weren't affected by barium density and had no differences in SUV. But in the PET/CT images using CT Tx data, there's considerable variations in HU and SUV values according to a difference of barium density in HU values. To perform a precise examination, barium sulfate should be removed from a human body before performing a PET exam.

• Journal of Gastric Cancer
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• v.8 no.4
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• pp.250-255
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• 2008

Purpose: The purpose of this study was to assess the diagnostic value of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) for detecting the lymph node (LN) metastasis of gastric cancer. Materials and Methods: 119 patients (M : F=89 : 30; mean age: 64) with gastric cancer were referred for preoperative FDG-PET/CT scanning and spiral enhanced abdominal pelvic CT from June 2006 to July 2008, and these were the subjects of our study. All the patients underwent curative radical gastrectomy and lymph node dissection. A final diagnosis was made for all the patients by the histology of the surgical specimens. Results: Both PET/CT and enhanced CT showed similar sensitivity for detecting regional lymph node metastasis (32.6% vs 39.5%, respectively). PET/CT was more accurate than enhanced CT for detecting regional lymph node metastasis (67.2% vs 63.0%, respectively), and PET/CT showed better specificity (86.8% vs 76.3, respectively) and a better positive predictive value (PPV) (58.3% vs 48.6%, respectively). PET/CT showed better specificity (98.0% vs 88.2%, respectively) and accuracy (79.4% vs 73.9%, respectively) than enhanced CT for detecting early gastric cancer. PET/CT showed better specificity (64.0% vs 52.0%, respectively), a better PPV (60.9% vs 57.1%), a better negative predictive value (NPV) (48.5% vs 46.4%, respectively) and better accuracy (53.6% vs 51.8%, respectively) than enhanced CT for detecting advanced gastric cancer. Conclusion: FDG-PET/CT is more usefulness than enhanced CT for making the preoperative diagnosis of regional LN metastases from gastric cancers.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.6
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• pp.309-315
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• 2006

Purpose: Accurate evaluation of cervical lymph node (LN) metastasis of head and neck squamous cell canter (SCC) is important to treatment planning. We evaluated the diagnostic accuracy of F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) for the detection of cervical LN metastasis of head and neck SCC and performed a retrospective comparison with CT/MRI findings. Materials & Methods: Seventeen patients with pathologically proven head and neck SCC underwent F-18 FDG PET/CT and CT/MRI within 4 week before surgery. We recorded lymph node metastases according to the neck level system of imaging-based nodal classification. F-18 FDG PET/CT images were analyzed visually for assessment of regional tracer uptake in LN. We analyzed the differences in sensitivity and specificity between F-18 FDG PET/CT and CT/MRI using the Chi-square test. Results: Among the 17 patients, a total of 123 LN levels were dissected, 29 of which showed metastatic involvement. The sensitivity and specificity of F-18 FDG PET/CT for detecting cervical LN metastasis on a level-by-level basis were 69% (20/29) and 99% (93/94). The sensitivity and specificity of CT/MRI were 62% (18/29) and 96% (90/94). There was no significant difference in diagnostic accuracy between F-18 FDG PET/CT and CT/MRI. Interestingly, F-18 FDG PET/CT detected double primary tumor (hepatocellular carcinoma) and rib metastasis, respectively. Conclusion: There was not statistically significant difference of diagnostic accuracy between F-18 FDG PET/CT and CT/MRI for the detection of cervical LN metastasis of head and neck SCC. The low sensitivity of F-18 FDG PET/CT was due to limited resolution for small metastatic deposits.

• The Journal of the Korean bone and joint tumor society
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• v.14 no.2
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• pp.86-94
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• 2008

$^{18}F$-FDG PET/CT has led to advancement in diagnostic imaging, providing correlation of both physiology and anatomic information, and to new and innovative ways to utilize PET/CT imaging for the evaluation of musculoskeletal tumors. Recently, the most widely utilized musculoskeletal application of PET/CT imaging is for the detection and characterization of bone metastases, staging and restaging of primary malignant bone tumors and soft tissue sarcomas. And it is also useful in evaluating response to therapy for malignant musculoskeletal tumors and in detecting local recurrences or distant metastases during follow up. The future likely holds even more unique and potentially quite useful applications of PET/CT imaging for primary bone and soft tissue tumors. This article will review the useful applications of $^{18}F$-FDG PET/CT imaging for evaluating musculoskeletal tumors.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.2
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• pp.7-11
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• 2012

Purpose : The effect of concomitant use of $^{18}F$-FDG and intravenous contrast agent (CA) on dual-energy X-ray absorptiometry (DXA), was rarely reported. We had investigated these potentially confounding effects. Materials and Methods : Twenty-two patients had undergone DXA before and immediately after $^{18}F$-FDG PET/CT scans. Two DXA and 1 PET/CT scans had performed within one-day. $^{18}F$-FDG PET/CT scans had been performed with CA in 17 patients and without CA in 5 patients. Whole body bone mineral content (BMC), whole body bone mineral density (BMD), total fat mass (TFM), and lean body mass (LBM) were measured by DXA scanner before and after the $^{18}F$-FDG PET/CT scans. Results : BMC, BMD, TFM and LBM had significantly affected by $^{18}F$-FDG PET/CT with CA (BMC, +13.7%, from $2061.3{\pm}393.7$ to $2343.4{\pm}373.3$; BMD, +9.3%, from $1.07{\pm}0.09$ to $1.17{\pm}0.08$; TFM, -34.1%, from $17052.1{\pm}4049.9$ to $11237.1{\pm}2990.3$; LBM, +13.6%, from $45834.5{\pm}5662.1$ to $52094.0{\pm}6335.4$). However, $^{18}F$-FDG PET/CT without CA had no effect on the measurement of DXA (BMC, +2.4%, from $2197.7{\pm}391.6$ to $2251.5{\pm}380.9$; BMD, +1.8%, from $1.13{\pm}0.09$ to $1.15{\pm}0.07$; TFM, -6.8%, from $14585.6{\pm}3455.9$ to $13591.3{\pm}4351.4$; LBM, +2.2%, from $47360.5{\pm}8381.8$ to $48441.1{\pm}8488.1$). Conclusion : The measurements of DXA are affected by using CA. However, DXA scans might be unaffected by the presence of $^{18}F$-FDG administered for PET/CT.