• 대한정형외과학회지
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• 제56권5호
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• pp.398-403
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• 2021

목적: 연부조직 종양의 진단을 위해서는 생검이 필요하지만, 육종 등 이질성을 가진 종양들의 특징상 정확한 부위의 채취가 어려워 수술적 개방 생검으로도 진단이 어려운 경우가 많다. 이 경우 초음파 유도하 침생검이 진단율을 올릴 수 있는 방법으로 사용되고 있다. 본 연구는 자기공명 관류영상(magnetic resonance perfusion)에서 발견된 연부조직 종양을 진단하는 데 있어 초음파 유도하 침 생검의 정확도를 평가하고, 양전자방출 컴퓨터 단층촬영술(positron emission tomography-computed tomography, PET-CT)의 유용성에 대해 알고자 하였다. 대상 및 방법: 2014년 1월부터 2018년 12월까지 자기공명 관류영상에서 발견된 연부조직의 종양에 대해 초음파 유도하 침 생검을 시행한 총 152예의 환자들 중 최종 진단을 얻어 초음파 유도하 침 생검의 결과와 비교할 수 있었던 86예에 대해 그 정확도를 후향적으로 평가하였다. 총 86예의 환자를 자기공명 관류영상만을 시행한 50예와 자기공명 관류영상과 PET-CT를 함께 시행한 36예로 나누어 그 정확도를 비교, 분석하여 PET-CT가 초음파 유도하 침 생검의 정확도를 향상시킬 수 있는지 알고자 하였다. 결과: 총 86예의 환자들 중 자기공명 관류영상만을 시행한 50예 중에서는 34예에서 최종 진단과 초음파 유도하 침 생검의 결과가 일치하였으며, 자기공명 관류영상과 PET-CT를 함께 시행한 36예 중에서는 32예에서 최종 진단과 초음파 유도하 침 생검의 결과가 일치하여 초음파 유도하 침 생검의 정확도에 있어 유의한 차이를 보였다. 이 중 연부 조직 육종만 따로 분류한다면 자기공명 관류영상만을 시행한 12예 중에서 6예에서 최종 진단과 초음파 유도하 침 생검의 결과가 일치하였고 자기공명 관류영상과 PET-CT를 함께 시행한 18예 중에서는 17예에서 최종 진단과 초음파 유도하 침 생검의 결과가 일치하여 마찬가지로 초음파 유도하 침 생검의 정확도에 있어 유의한 차이를 보였다. 결론: 연부조직 종양을 진단함에 있어 초음파 유도하 침 생검은 정확도가 높은 유용한 검사로 알려져 있지만 육종의 경우 이질성이 있어 자기공명 관류영상만으로는 정확한 생검 부위를 설정하는 데 어려움이 있다. PET-CT 영상은 이러한 연부조직 종양에서 침 생검 부위를 특정하고 정확도를 유의하게 향상시킬 수 있을 것으로 생각된다.

• Journal of Gastric Cancer
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• 제18권3호
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• pp.218-229
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• 2018

Purpose: This study investigated whether the metabolic avidity of primary tumors and/or metastatic lymph nodes (LNs) measured by $^{18}F$-fluorodeoxyglucose ($^{18}F-FDG$) positron emission tomography/computed tomography (PET/CT) was related to survival after surgery in patients with advanced gastric cancer (AGC). Materials and Methods: One hundred sixty-eight patients with AGC who underwent preoperative $^{18}F-FDG$ PET/CT and curative resection were included. The $^{18}F-FDG$ avidity of the primary gastric tumor and LNs was determined quantitatively and qualitatively. The diagnostic performance of $^{18}F-FDG$ PET/CT was calculated, and the prognostic significance of $^{18}F-FDG$ avidity for recurrence-free survival (RFS) and overall survival (OS) was assessed. Results: In all, 51 (30.4%) patients experienced recurrence, and 32 (19.0%) died during follow-up (median follow-up duration, 35 months; range, 3-81 months); 119 (70.8%) and 33 (19.6%) patients showed $^{18}F-FDG$-avid primary tumors and LNs, respectively. $^{18}F-FDG$ PET/CT showed high sensitivity (73.8%) for the detection of advanced pathologic T ($pT{\geq}3$) stage and high specificity (92.2%) for the detection of advanced pN (${\geq}2$) stage. $^{18}F-FDG$ avidity of LNs was significantly associated with RFS (P=0.012), whereas that of primary tumors did not show significance (P=0.532). Univariate and multivariate analyses revealed that $^{18}F-FDG$ avidity of LNs was an independent prognostic factor for RFS (hazard ratio=2.068; P=0.029). Conclusions: $^{18}F-FDG$ avidity of LNs is an independent prognostic factor for predicting RFS. Preoperative $^{18}F-FDG$ PET/CT can be used to determine the risk and prognosis of patients with AGC after curative resection.

• Journal of Gynecologic Oncology
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• 제29권6호
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• pp.98.1-98.13
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• 2018

Objective: We describe a systematic review and meta-analysis of the performance of ${18}F$-fluorodeoxyglucose ($^{18}F-FDG$) positron emission tomography/computed tomography (PET/CT) for detecting metastasis in ovarian cancer. Methods: MEDLINE and Embase were searched for diagnostic accuracy studies that used $^{18}F-FDG$ PET or PET/CT for pre-treatment staging, using surgical findings as the reference standard. Sensitivities and specificities were pooled and plotted in a hierarchic summary receiver operating characteristic plot. Potential causes of heterogeneity were explored through sensitivity analyses. Results: Eight studies with 594 patients were included. The overall pooled sensitivity and specificity for metastasis were 0.72 (95% confidence interval [CI]=0.61-0.81) and 0.93 (95% CI=0.85-0.97), respectively. There was considerable heterogeneity in sensitivity ($I^2=97.57%$) and specificity ($I^2=96.74%$). In sensitivity analyses, studies that used laparotomy as the reference standard showed significantly higher sensitivity and specificity (0.77; 95% CI=0.67-0.87 and 0.96; 95% CI=0.92-0.99, respectively) than those including diagnostic laparoscopy (0.62; 95% CI=0.46-0.77 and 0.84; 95% CI=0.69-0.99, respectively). Higher specificity was shown in studies that confirmed surgical findings by pathologic evaluation (0.95; 95% CI=0.90-0.99) than in a study without pathologic confirmation (0.69; 95% CI=0.24-1.00). Studies with a lower prevalence of the FDG-avid subtype showed higher specificity (0.97; 95% CI=0.94-1.00) than those with a greater prevalence (0.89; 95% CI=0.80-0.97). Conclusion: Pre-treatment $^{18}F-FDG$ PET/CT shows moderate sensitivity and high specificity for detecting metastasis in ovarian cancer. With its low false-positive rate, it can help select surgical approaches or alternative treatment options.

• Korean Journal of Radiology
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• 제21권7호
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• pp.829-837
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• 2020

Objective: The aim of this study was to investigate the prognostic value of the maximum standardized uptake value (SUV_max) measured while restaging with F-18 fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) to predict the 3-year post-recurrence survival (PRS) in patients with recurrent gastric cancer after curative surgical resection. Materials and Methods: In total, 47 patients with recurrent gastric cancer after curative resection who underwent restaging with ¹⁸F-FDG PET/CT were included. For the semiquantitative analysis, SUV_max was measured over the visually discernable ¹⁸F-FDG-avid recurrent lesions. Cox proportional-hazards regression models were used to predict the 3-year PRS. Differences in 3-year PRS were assessed with the Kaplan-Meier analysis. Results: Thirty-nine of the 47 patients (83%) expired within 3 years after recurrence in the median follow-up period of 30.3 months. In the multivariate analysis, SUV_max (p = 0.012), weight loss (p = 0.025), and neutrophil count (p = 0.006) were significant prognostic factors for 3-year PRS. The Kaplan-Meier curves demonstrated significantly poor 3-year PRS in patients with SUV_max > 5.1 than in those with SUV_max ≤ 5.1 (3-year PRS rate, 3.5% vs. 38.9%, p < 0.001). Conclusion: High SUV_max on restaging with ¹⁸F-FDG PET/CT is a poor prognostic factor for 3-year PRS. It may strengthen the role of ¹⁸F-FDG PET/CT in further stratifying the prognosis of recurrent gastric cancer.

• 대한방사성의약품학회지
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• 제7권2호
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• pp.99-103
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• 2021

In this study, the initial in vivo pharmacokinetic changes according to the routes of drug administration were investigated using bioimaging techniques. The purpose of this study was to quantify the degree of distribution of each major organ in normal mice over time by acquiring Positron Emission Tomography/Computed Tomography images while administering routes F-18 fluorodeoxyglucose such as intravenous, intraperitoneal and per oral, a representative diagnostic radiopharmaceutical. Dynamic Positron Emission Tomography images were acquired for 90 minutes after drug administration. Radioactivity uptake was calculated for major organs using the PMOD program. In the case of intravenous administration, it was confirmed that it spread quickly and evenly to major organs. Compared to intravenous administration, intraperitoneal administration was about three times more absorbed and distributed in the liver and intestine, and it was showed that the amount excreted through the bladder was more than twice. In the case of oral administration, most stayed in the stomach, and it was showed that it spread slowly throughout the body. In comparison with intravenous administration, it was presented that the distribution of kidneys was more than 9 times and the distribution of bladder was 66% lower. Since there is a difference in the initial in vivo distribution and excretion of each administration method, we confirmed that the determination of the administration route is important for in vivo imaging evaluation of new drug candidates.

• 한국방사선학회논문지
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• 제16권5호
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• pp.499-504
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• 2022

양전자방출단층촬영기기(positron emission tomography, PET)는우수한 공간분해능을 달성하기 위해 매우 작은 섬광체를 사용한다. 이에 본 연구에서는 0.8 mm 크기의 섬광체를 사용한 PET 시스템을 설계하여 성능을 평가하였다. 관심 시야(field of view, FOV) 중심에서부터 10 mm 간격으로 외곽에 이르는 위치에서 소멸방사선을 발생시켜 동시계수하였다. 획득한 데이터를 사용하여 영상을 재구성하였으며, 프로파일을 통해 반치폭을 획득하여 공간분해능을 계산하였다. FOV 중심에서 공간분해능은 1.02 mm로 매우 우수한 결과를 보였으며, 외곽에 위치할수록 공간분해능은 저하되는 특징을 보였다. 팬텀 영상을 평가하기 위해 Derenzo 팬텀을 구성하여 영상을 획득하였으며, 프로파일 분석을 통해 선원간 구분 정도를 평가하였다. 각 위치별 선원의 공간분해능에 비해 선원간의 간격이 더 큰 결과를 보였으며, 이를 통해 모든 위치의 선원들이 구분되는 것을 확인할 수 있었다. 본 연구에서 설계한 PET 시스템을 소동물용 PET에 적용할 경우 매우 우수한 공간분해능을 특성을 통해 우수한 성능을 확보할 수 있을 것으로 판단된다.

• Journal of Chest Surgery
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• 제45권3호
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• pp.189-191
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• 2012

Graft infections after aortic replacement are a rare, but severe complication. Because surgical removal of the infection source is essential, an accurate diagnosis is required to prevent unnecessary treatment. Both of the patients described herein were diagnosed with graft infections using dual-modality positron emission tomography-computed tomography; one patient was a false-positive, and the other was confirmed with an infection.

• 대한방사성의약품학회지
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• 제5권1호
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• pp.36-47
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• 2019

Hypoxia-inducible factor-1 ($HIF-1{\alpha}$) is a transcription factor activated in response to low oxygen level, and is highly expressed in many solid tumors. Moreover, $HIF-1{\alpha}$ is a representative biomarker of hypoxia and also helps to maintain cell homeostasis under hypoxic condition. Most solid tumors show hypoxia, which induces poor prognosis and resistance to conventional cancer therapies. Thus, early diagnosis of hypoxia with positron emission tomography (PET) radiotracer would be highly beneficial for management of malignant solid tumors with effective cancer therapy. YC-1 is a most promising candidate among several $HIF-1{\alpha}$ inhibitors. As an effort to develop a hypoxia imaging tool as a PET radiotracer, we designed and synthesized [$^{18}F$]DFYC based on potent derivative of YC-1 and performed preliminary in vitro cell uptake study. [$^{18}F$]DFYC showed a significant accumulation in SKBR-3 cells among other cancer cells, proving as a good lead to develop a hypoxic solid tumor such as breast cancer.

• 방사선산업학회지
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• 제9권3호
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• pp.143-151
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• 2015

A PET-MR system is particularly useful in diagnosing brain diseases. We have developed a prototype positron emission tomography (PET) system which can be inserted into the bore of a whole-body magnetic resonance imaging (MRI) system that enables us to obtain PET and MRI images simultaneously with a reduced cost. Silicon photomultipliers (SiPM) are appropriated as a PET detector at PET/MR system because detectors have a high gain and are insensitive to magnetic fields. Despite of its improved performance compared to that of PMT-based detectors, there is a problem of the photo-peak channel shift which is due to the increase of the temperature inside the ring detector. This problem will occur decreasing sensitivity of the PET and image distortion. In this paper, I quantitative analyze parameters of the KAIST SiPM depending on temperature by experiments. And I designed cooling methods in consideration of the degradation of sensors for correction of the temperature in the PET gantry. According to this research, we expect that distortive images and degradation of the sensitivity will not be occurred with using the above idea to reduce heat even if the PET system operates for a long time.

• Korean Journal of Radiology
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• 제20권6호
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• pp.967-975
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• 2019

Objective: To evaluate whether the combination of magnetic resonance spectroscopy (MRS) and ¹¹C-methionine positron emission tomography (¹¹C-MET PET) could increase accurate diagnostic sensitivity for non-enhancing supratentorial gliomas. Materials and Methods: Between February 2012 and December 2017, 109 patients with non-enhanced supratentorial lesions on contrast-enhanced MRI were enrolled. Each patient underwent MRS and ¹¹C-MET PET before treatment. A lesion was considered to be a glioma when either the MRS or ¹¹C-MET PET results reached the diagnostic threshold. The radiological diagnosis was compared with the pathological diagnosis or medical diagnostic criteria. Results: The sensitivity and specificity were 60.0% and 50.0% for MRS and 75.8% and 50.0% for ¹¹C-MET PET, respectively. Upon combining the two modalities, the sensitivity and specificity of the imaging-based diagnosis prior to surgery reached 89.5% and 42.9%, respectively. Statistically significant differences in the sensitivities were observed between the combined and individual approaches (MRS alone, 89.5% vs. 60.0%, p < 0.001; ¹¹C-MET PET alone, 89.5% vs. 75.8%, p = 0.001). However, no significant differences in specificity were observed between the combined and individual modalities. Conclusion: The combination of MRS and ¹¹C-MET PET findings significantly increases accurate diagnostic sensitivity for non-enhancing supratentorial gliomas without significantly lowering the specificity. This finding suggests the potential of the combined MRS and ¹¹C-MET PET approach in clinical applications.