• 대한치매학회지
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• 제17권4호
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• pp.163-173
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• 2018

Background and Purpose: Behavioral variant frontotemporal dementia (bvFTD) is a subtype of frontotemporal dementia, which has clinical symptoms of progressive personality and behavioral changes with deterioration of social cognition and executive functions. The pathology of bvFTD is known to be tauopathy or TDP-43 equally. We analyzed the $^{18}F-THK5351$ positron emission tomography (PET) scans, which were recently developed tau PET, in patients with clinically-diagnosed bvFTD. Methods: Forty-eight participants, including participants with behavioral variant frontotemporal dementia (bvFTD, n=3), Alzheimer's disease (AD, n=21) and normal cognition (NC, n=24) who completed 3T magnetic resonance images, $^{18}F-THK5351$ PET scans, and detailed neuropsychological tests were included in the study. Voxel-wise statistical analysis and region of interest (ROI)-based analyses were performed to evaluate the retention of THK in bvFTD patients. Results: In the voxel-based and ROI-based analyses, patients with bvFTD showed greater THK retention in the prefrontal, medial frontal, orbitofrontal, anterior cingulate, insula, anterior inferior temporal and striatum regions compared to NC participants. Left-right asymmetry was noted in the bvFTD patients. A patient with extrapyramidal symptoms showed much greater THK retention in the brainstem. Conclusions: The distribution of THK retention in the bvFTD patients was mainly in the frontal, insula, anterior temporal, and striatum regions which are known to be the brain regions corresponding to the clinical symptoms of bvFTD. Our study suggests that $^{18}F-THK5351$ PET imaging could be a supportive tool for diagnosis of bvFTD.

• Radiation Oncology Journal
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• 제30권4호
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• pp.173-181
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• 2012

Purpose: To evaluate the prognostic value of preoperative neck lymph node (LN) assessment with $^{18}F$-fluorodeoxyglucose positron emission tomography ($^{18}F$-FDG PET), computed tomography (CT), and magnetic resonance imaging (MRI) in oral cavity squamous cell carcinoma (OSCC) patients with pathologically positive LN. Materials and Methods: In total, 47 OSCC patients with pathologically positive LN were retrospectively reviewed with preoperative $^{18}F$-FDG PET and CT/MRI. All patients underwent surgical resection, neck dissection and postoperative adjuvant radiotherapy and/or chemotherapy between March 2002 and October 2010. Histologic correlation was performed for findings of $^{18}F$-FDG PET and CT/MRI. Results: Thirty-six (76.6%) of 47 cases were correctly diagnosed with neck LN metastasis by $^{18}F$-FDG PET and 32 (68.1%) of 47 cases were correctly diagnosed by CT/MRI. Follow-up ranged from 20 to 114 months (median, 56 months). Clinically negative nodal status evaluated by $^{18}F$-FDG PET or CT/MRI revealed a trend toward better clinical outcomes in terms of overall survival, disease-free survival, local recurrence-free survival, regional nodal recurrence-free survival, and distant metastasis-free survival rates even though the trends were not statistically significant. However, there was no impact of neck node standardized uptake value ($SUV_{max}$) on clinical outcomes. Notably, $SUV_{max}$ showed significant correlation with tumor size in LN (p < 0.01, $R^2$ = 0.62). PET and CT/MRI status of LN also had significant correlation with the size of intranodal tumor deposit (p < 0.05, $R^2$ = 0.37 and p < 0.01, $R^2$ = 0.48, respectively). Conclusion: $^{18}F$-FDG PET and CT/MRI at the neck LNs might improve risk stratification in OSCC patients with pathologically positive neck LN in this study, even without significant prognostic value of $SUV_{max}$.

• Radiation Oncology Journal
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• 제35권4호
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• pp.340-348
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• 2017

Purpose: To evaluate the diagnostic accuracy of computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography/computed tomography (PET/CT) in predicting pelvic lymph node (LN) metastases in patients with cervical cancer. Materials and Methods: From January 2009 to March 2015, 114 patients with FIGO stage IA1-IIB uterine cervical cancer who underwent hysterectomy with pelvic lymphadenectomy and took CT, MRI, and PET/CT before surgery were enrolled in this study. The criteria for LN metastases were a LN diameter ${\geq}1.0cm$ and/or the presence of central necrosis on CT, a LN diameter ${\geq}1.0cm$ on MRI, and a focally increased FDG uptake on PET/CT. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for pelvic LN metastases were estimated. Results: The sensitivity, specificity, PPV, NPV, and accuracy for detection of pelvic LN metastases were 51.4%, 85.9%, 41.3%, 90.1%, and 80.3% for CT; 24.3%, 96.3%, 56.3%, 86.8%, and 84.6% for MRI; and 48.6%, 89.5%, 47.4%, 90.0%, and 82.9% for PET/CT, respectively. The sensitivity of PET/CT and CT was higher than that of MRI (p=0.004 and p= 0.013, respectively). The specificity of MRI was higher than those of PET/CT and CT (p=0.002 and p=0.001, respectively). The difference of specificity between PET/CT and CT was not statistically significant (p=0.167). Conclusion: These results indicate that preoperative CT, MRI, and PET/CT showed low to moderate sensitivity and PPV, and moderate to high specificity, NPV, and accuracy. More efforts are necessary to improve sensitivity of imaging modalities in order to predict pelvic LN metastases.

• 대한핵의학회지
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• 제36권1호
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• pp.34-38
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• 2002

Positron emission tomography(PET) is an imaging method that employs radionuclide and tomography techniques. Since 1995, we applied PET not only to the diagnosis of breast cancer but also to the detection of abnormalities in the augmented breast and to the detection of metastasis. Until 2001, we evaluated 242 breast cases by PET at PET center of Seoul National University Hospital. Our group has reported serially at the international journals. In the first report, PET showed high sensitivity for detecting breast cancer, both the primary and axillary node metastasis. A total of 27 patients underwent breast operations based on PET results at Seoul National University Hospital from 1995 to 1996. The diagnostic accuracy of PET were 97% for the primary tumor mass and 96% for axillary lymph node metastasis. In case of the breast augmented, PET also showed excellent diagnostic results for primary breast cancer and axillary lymph node metastasis where mammography and ultrasound could not diagnose properly. PET also had outstanding results in the detection of recurrent or metastatic breast cancer(sensitivity 94%, specificity 80%, accuracy 89%). In addition, our study gave some evidence that PET could be applied further to evaluate the growth rate of tumors by measuring SUV, and finally to prognosticated the disease. PET could also be applied to evaluate the response after chemotherapy to measure its metabolic rate and size. In conclsion, PET is a highly sensitive, accurate diagnostic tool for breast cancer of primary lesion in various conditions including metastasis.

• Tuberculosis and Respiratory Diseases
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• 제71권6호
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• pp.425-430
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• 2011

Background: High 2-[$^{18}F$] fluoro-2-deoxy-D-glucose (FDG) uptake on positron emission tomography-computed tomography (PET-CT) is a prognostic factor for poor survival in non-small cell lung cancer (NSCLC), especially in Stage I. We determined whether the high FDG uptake value of a primary tumor was associated with recurrence and death in patients with resected Stage I and Stage II NSCLC. Methods: We identified consecutive patients who underwent complete surgical resection for Stage I and II NSCLC between 2006 and 2009, who had preoperative PET-CT, and reviewed clinical records retrospectively. FDG uptake was measured as the maximal standardized uptake value (SUVmax) for body weight. Patients were divided into two groups based on SUVmax: (i) above or (ii) below the cut-off value (SUVmax=5.9) determined by a receiver operating characteristic (ROC) curve. Results: Of 57 patients who were enrolled consecutively, 32 (56%) had Stage I NSCLC and 25 (44%) had Stage II. The 5-year recurrence-free survival (RFS) for patients with high (${\geq}5.9$) and low (<5.9) SUVmax were 31% and 57%, respectively (p=0.014). The 5-year overall survival (OS) rates were 39% and 60%, respectively (p=0.029). In univariate analyses, SUVmax (p=0.014), T staging (p=0.025), and differentiation of tumor tissue (p=0.034) were significantly associated with RFS. But, multivariate analyses did not show that SUVmax was an independently significant factor for RFS (p=0.180). Conclusion: High FDG uptake on PET-CT is not an independent prognostic factor for poor outcomes (disease recurrence in patients with resected Stage I and II NSCLC).

• 대한핵의학회지
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• 제29권4호
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• pp.533-540
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• 1995

정량적인 PET 영상에서는 감쇠보정이 매우 중요하며 가장 정확한 방법은 투과스캔을 관심부위에 실시하여 측정된 감쇠보정영상을 만들고, 이를 같은 부위에서 실시한 방출 영상의 재구성에 적용하는 것이다. 기존의 방법은 투과스캔 후에 추적자가 섭취되기까지 장시간이 경과된 후 방출스캔을 하므로 PET스캐너의 효율적 사용에 제한이 있었다. 따라서, 스캔시간을 단축하고 촬영중 환자가 움직일 가능성을 최소화시켜 영상의 질을 개선하고 PET스캐너의 효율을 높이기 위하여, 추적자를 주사한 후 투과 및 방출스캔을 동시에 실시하여, 투과스캔에서의 측정치를 왜곡시키는 방출계수를 빼주는 T+E 감쇠보정 방법을 실행하였다. 배후에는 F-l8 fluoride ion $0.4{\mu}Ci/cc$의 방사능을 가진 물을 실린더 모형(5750 cc)에 채우고, 목적물을 나다내는 1개의 삽입물 실린더(276 cc)에는 F-18 fluoride ion $4.3{\mu}Ci/cc$의 방사능을 주입하고 공기를 주입한 삽입물 실린더와 테플론으로 이루어진 삽입물 실린더를 사용하여 T+E 방법의 특성을 고찰하였다. 투과용선원으로 Ge-68(10 mCi) 회전 핀선원을 사용하여 5시간 동안에 T+E 스캔을 5분, 10분, 20분, 방출스캔을 20분씩 교대로 5차례 실행하여 투과 및 방출영상이 최종 방출영상에 미치는 오차를 측정하였다. T+E 스캔으로 감쇠보정한 방출영상과 기준 투과영상으로 감쇠보정한 방출영상을 비교하면, 목적물의 방사능이 $1.0{\mu}Ci/cc$일 경우 T+E 감쇠보정 방법의 오차는 2.6%이었으며 이 오차는 목적물의 방사능이 줄어들수록 더욱 감소하였다. 또한, T+E 방법으로 구성된 방출영상의 노이즈는 기준 투과스캔 방법으로 보정된 영상에 비하여 유의한 차이를 보이지 않았다. 그러므로, 회전 핀선원과 투과 및 방출 동시 영상 방법을 사용하여 정확한 감쇠보정을 할 수 있었으며 이 방법은 임상 PET 영상에서 환자당 스캔시간을 줄임으로써, 환자의 움직임으로 인하여 발생할 수 있는 오차를 최소화하여 PET 스캐너의 효율을 높일 수 있었다.

• Nuclear Medicine and Molecular Imaging
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• 제40권5호
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• pp.271-274
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• 2006

We report the case of a 64-year-old man with superior vena cava (SVC) syndrome due to tumor thrombus from recurrent hepatocellular carcinoma (HCC). He presented with new onset of facial swelling for 10 days. HCC was detected ten years ago. He has undergone repeated transcatheter arterial embolization (TAE) and chemotherapy. Chest computed tomography (CT) demonstrated tumor thrombus in the SVC extending to right atrium. He underwent whole body F-18 fluorodeoxyglucose(FDG) positron emission tomography/computed tomography (PET/CT) scanning for assessing the effect of TAE in HCC. F-18 FDG PET/CT showed increased uptake in the residual liver mass indicating viable tumor. There was another intense F-18 FDG accumulation in SUV extending to right atrium to suggest tumor thrombus. This case illustrates that F-18 FDG PET/CT is useful to identification of distant metastases as well as assessment of response to therapy in long-term survival HCC patients.

• Nuclear Engineering and Technology
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• 제51권6호
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• pp.1610-1615
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• 2019

Positron emission tomography (PET)/magnetic resonance (MR) scanning has the advantage of less additional exposure to radiation than does PET/computed tomography (CT). In particular, MR based attenuation correction (MR AC) can greatly affect the image quality of PET and is frequently obtained using various MR sequences. Thus, the purpose of the current study was to quantitatively compare the image quality between MR non-AC (MR NAC) and MR AC in PET images with three MR sequences. Percent image uniformity (PIU), percent contrast recovery (PCR), and percent background variability (PBV) were estimated to evaluate the quality of PET images with MR AC. Based on the results of PIU, 15.2% increase in the average quality was observed for PET images with MR AC than for PET images with MR NAC. In addition, 28.6% and 71.1% improvement in the average results of PCR and PBV respectively, was observed for PET images with MR AC compared with that with MR NAC. Moreover, no significant difference was observed among the average values using three MR sequences. In conclusion, the current study demonstrated that PET with MR AC improved the image quality and can be help diagnosis in all MR sequence cases.

• 대한임상검사과학회지
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• 제36권2호
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• pp.193-198
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• 2004

PET/CT combines the functional information from a positron emission tomography (PET) exam with the anatomical information from a computed tomography (CT) exam into one single exam. A CT scan uses a combination of x-rays and computers to give the radiologist a non-invasive way to see inside your body. One advantage of CT is its ability to rapidly acquire two-dimensional pictures of your anatomy. Using a computer these 2-D images can be presented in 3-D for in-depth clinical evaluation. A PET scan detects changes in the cellular function - how your cells are utilizing nutrients like sugar and oxygen. Since these functional changes take place before physical changes occur, PET can provide information that enables your physician to make an early diagnosis. The PET exam pinpoints metabolic activity in cells and the CT exam provides an anatomical reference. When these two scans are fused together, your physician can view metabolic changes in the proper anatomical context of your body. PET/CT offers significant advantages including more accurate localization of functional abnormalities, and the distinction of pathological from normal physiological uptake, and improvements in monitoring treatment. A PET/CT scan allows physicians to measure the body's abnormal molecular cell activity to detect cancer (such as breast cancer, lung cancer, colorectal cancer, lymphoma, melanoma and other skin cancers), brain disorders (such as Alzheimer's disease, Parkinson's disease, and epilepsy), and heart disease (such as coronary artery disease).

• 대한핵의학회지
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• 제36권1호
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• pp.39-45
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• 2002

Clinical application of positron emission tomography (PET) is rapidly increasing for the defection and staging of cancer at whole-body studios performed with the glucose analogue tracer 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). Although FDG PET cannot match the anatomic resolution of conventional imaging techniques in the liver and the other abdominal organs, it is particularly useful for identification and characterization of the entire body simultaneously. FDG PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can aid in the characterizing of indeterminate soft-tissue masses. Most abdominal cancer requires surgical management. FDG PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. The abdominal cancers, such as gastroesophageal cancer, colorectal cancer, liver cancer and pancreatic cancer, are common malignancies in Korea, and PET is one of the most promising and useful methodologies for the management of abdominal cancers.