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Accuracy of FDG-PET/CT for Detection of Incidental Pre-Malignant and Malignant Colonic Lesions - Correlation with Colonoscopic and Histopathologic Findings

  • Kunawudhi, Anchisa;Wong, Alexandra K;Alkasab, Tarik K;Mahmood, Umar
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.8
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    • pp.4143-4147
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    • 2016
  • Purpose: We evaluated all PET/CTs acquired for patients without a primary diagnosis of colorectal cancer, and compared results for those who had subsequent colonoscopy within 6 months, to assess the accuracy of FDG PET/CT for detection of incidental pre-malignant polyps and malignant colon cancers. Materials and Methods: Medical records of 9,545 patients who underwent F-18 FDG PET/CT studies over 3.5 years were retrospectively reviewed. Due to pre-existing diagnosis of colorectal cancer, 818 patients were excluded. Of the remainder, 157 patients had colonoscopy within 6 months (79 males; mean age 61). We divided the colon into 4 regions and compared PET/CT results for each region with colonoscopy and histopathologic findings. True positive lesions included colorectal cancer, villous adenoma, tubulovillous adenoma, tubular adenoma and serrated hyperplastic polyp/hyperplastic polyposis. Results: Of 157 patients, 44 had incidental colonic uptake on PET/CT (28%). Of those, 25 had true positive (TP) uptake, yielding a 48% positive predictive value (PPV); 9% (4/44) were adenocarcinoma. There were 23 false positive (FP) lesions of which 4 were hyperplastic polyp, one was juvenile polyp and 7 were explained by diverticulitis. Fifty eight patients had false negative PET scans but colonoscopy revealed true pre-malignant and malignant pathology, yielding 23% sensitivity. The specificity, negiative predictive value (NPV) and accuracy were 96%, 90% and 87%, respectively. The average SUVmax values of TP, FP and FN lesions were 7.25, 6.11 and 2.76, respectively. There were no significant difference between SUVmax of TP lesions and FP lesions (p>0.95) but significantly higher than in FN lesions (p<0.001). The average size (by histopathology and colonoscopy) of TP lesions was 18.1 mm, statistically different from that of FN lesions which was 5.9 mm (p<0.001). Fifty-one percent of FN lesions were smaller than 5 mm (29/57) and 88% smaller than 10 mm (50/57). Conclusions: The high positive predictive value of incidental focal colonic FDG uptake of 48% for colonic neoplasia suggests that colonoscopy follow-up is warranted with this finding. We observed a low sensitivity of standardly acquired FDG-PET/CT for detecting small polyps, especially those less than 5 mm. Clinician and radiologists should be aware of the high PPV of focal colonic uptake reflecting pre-malignant and malignant lesions, and the need for appropriate follow up.

Practical Considerations of Arterial Spin Labeling MRI for Measuring the Multi-slice Perfusion in the Human Brain (스핀 라벨링 자기공명영상을 이용한 사람 뇌에서의 뇌 관류영상의 현실적 문제점을 향상 시키는 방법 연구)

  • Jahng, Geon-Ho
    • Progress in Medical Physics
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    • v.18 no.1
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    • pp.35-41
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    • 2007
  • In this work practical considerations of a pulsed arterial spin labeling MRI are presented to reliable multi-slice perfusion measurements In the human brain. Three parameters were considered in this study. First, In order to improve slice profile and Inversion efficiency of a labeling pulse a high power Inversion pulse of adiabatic hyperbolic secant was designed. A $900^{\circ}$ rotation of the flip angle was provided to make a good slice profile and excellent Inversion efficiency. Second, to minimize contributions of a residual magnetization be4ween Interleaved scans of control and labeling we tested three different conditions which were applied 1) only saturation pulses, 2) only spotter gradients, and 3) combinations of saturation pulses and spotter gradients Applications of bo4h saturation pulses and spoiler gradients minimized the residual magnetization. Finally, to find a minimum gap between a tagged plane and an imaging plane we tested signal changes of the subtracted image between control and labeled Images with varying the gap. The optimum gap was about 20mm. In conclusion, In order to obtain high quality of perfusion Images In human brain It Is Important to use optimum parameters. Before routinely using In clinical studios, we recommend to make optimizations of sequence parameters.

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Effects of CS682, a Fermentation Product of Korean Soil Bacteria, on Growth Performance in Chickens and Pigs (토착미생물 발효물인 CS682의 급여가 닭과 돼지의 생산성에 미치는 영향)

  • Kim, Hu-Kyung;Kim, Se-Eun;Shim, Kyung-Mi;Kim, Jong-Choon;Bae, Chun-Sik;Choi, Seok-Hwa;Kang, Seong-Soo
    • Journal of Life Science
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    • v.20 no.2
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    • pp.231-236
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    • 2010
  • Antibiotics in veterinary medicine have been used to treat disease, promote growth rate and improve feed efficiency. However, alternative sources are needed because of of bacterial resistance to antibiotics and residues of antibiotics. The present study was carried out to evaluate the effect of CS682, a fermentation product of Korean soil bacteria, on safety, growth rate and feed efficiency, and to evaluate its value as an alternative for antibiotics used as a feed additive. Two dosages of CS682 (0.1% and 1%) were fed to chickens for 28 days. The results showed that, when compared to chickens in the control group, growth and feed efficiency was improved. Also, mortality, hematology, general clinical signs and necropsy were examined. Chickens in the treatment groups showed no adverse effects. A total of 72 weaning pigs were used to confirm the effects of CS682 at one dose level (0.1%) regarding feed efficiency. Supplementation with 0.1% CS682 also resulted in improved weight gain and feed efficiency ratio. Based on these results, CS682 may be effective in improving feed efficiency safely as a feed additive.

Absorbed and effective dose for periapical radiography using portable and wall type dental X-ray machines (이동형 구내방사선촬영기와 벽걸이 구내방사선촬영기로 촬영한 치근단 방사선촬영에서 환자의 흡수선량과 유효선량 평가)

  • Han, Won-Jeong
    • The Journal of Korean Academy of Prosthodontics
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    • v.50 no.3
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    • pp.184-190
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    • 2012
  • Purpose: The purpose of this study was to measure the absorbed dose and to calculate the effective dose for one periapical radiography using the portable and wall type dental X-ray machines. Materials and methods: Thermoluminescent chips were placed at 25 sites throughout the layers of the head and neck of a tissue-equivalent human skull phantom. The man phantom was exposed with the portable and wall type dental X-ray machines. For one periapical radiography taken by portable dental X-ray machine, the exposure setting was 60 kVp, 2 mA and 0.2 seconds, while for one periapical radiography taken by wall type dental X-ray machine, exposure setting was 70 kVp, 8 mA and 0.074 seconds. Absorbed dose measurements were performed and equivalent doses to individual organs were summed using ICRP 103 to calculate effective dose. Results: In the upper anterior periapical radiography using portable dental X-ray machine and in the lower posterior periapical radiography using both machines, the highest absorbed dose was recorded at the mandible body. The effective dose in upper anterior periapical radiography using portable and wall type dental X-ray machines was $4{\mu}Sv$, $2{\mu}Sv$, respectively. In the lower posterior periapical radiography, the effective dose for each portable and wall type dental X-ray machines was $6{\mu}Sv$, $2{\mu}Sv$. Conclusion: It was recommended that the operator use prudently potable dental X-ray machine because that the effective dose in the periapical radiography using wall type dental X-ray machine was lower than that in the periapical radiography using portable dental X-ray machine.

Effect of Porcine Cancellous Bones on Regeneration in Rats with Calvarial Defect (랫드의 두개골 결손부에서 돼지 해면질골이 골재생에 미치는 영향)

  • Yoo, Kyeong-Hoon;Kim, Se-Eun;Shim, Kyung-Mi;Park, Hyun-Jeong;Choi, Seok-Hwa;Kang, Seong-Soo
    • Journal of Life Science
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    • v.20 no.8
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    • pp.1207-1213
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    • 2010
  • The purpose of this study was to evaluate the effect of porcine cancellous bone as a scaffold in a rat calvarial defect model. Critical-sized defects were created in 30 male Sprague-Dawley rats. The animals were divided into critical defect (CD, n=10), $\beta$-tricalcium phosphate (TCP) graft (BT, n=10) and porcine cancellous bone graft (PCB, n=10) groups. Each defect was filled with $\beta$-TCP mixed with fibrin glue or porcine cancellous bone powder mixed with fibrin glue. In the CD group, the defect was left empty. All rats were sacrificed at 8 weeks after bone graft surgery, and bone formation was evaluated by gross observation, plain radiography, micro-computed tomography scanning and histological evaluation. Repair of bone defect was the least in the CD group, and significant new bone formation was observed in the PCB group. Grafting of porcine cancellous bone was more efficient for regenerating new bone than grafting $\beta$-TCP.

Usefulness of Magnetic Resonance Imaging after Serial Cranial Ultrasound in the Neonates Graduating Neonatal Intensive Care Unit (신생아 중환자실을 퇴원하는 고위험 환아에서 순차적인 뇌초음파 검사 후 시행한 자기 공명 영상의 유용성)

  • Kim, Ji-Hye
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.170-177
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    • 2008
  • Purpose : To evaluate usefulness of MR imaging after serial brain US in the high-risk neonates before discharge of the neonatal intensive care unit. Materials and Methods : Retrospective comparison of 412 US and 121 MR scans in 121 neonates and young infants were performed. Grading of germinal matrix/intraventricular hemorrhage (GMH/IVH) was performed and presence of intracranial hemorrhage other than GMH/IVH and parencyma lesions was also analyzed. Results : Among the 242 lateral ventricles, Seven GMH and 46 IVH were additionally detected by MRI. On the other hand, 30 GMH were only detected by US. US demonstrated Grade 1/2/3/4 GMH/IVH in 24/8/13/0 ventricles each, while each grades were identified in 3, 49, 10, 2 ventricles on MR images. Other intracranial lesions additionally detected on MR images were cerebral hemorrhage (n=4), cerebellar hemorrhage (n=4), extraaxial hemorrhage (n=8), diffuse excessive signal change of the white matter (n=72), non-cavitary lesion (n=4), encephalomalacia (n=2), and ventriculomegaly (n=5). Conclusion : MR imaging could be an excellent complimentary study after serial brain US for additional detection of the intracranial pathology, particularly IVH and white matter lesions, though US would be better in follow-up of GMH in some neonates.

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Current Status of Imaging Physics & Instrumentation In Nuclear Medicine (핵의학 영상 물리 및 기기의 최신 동향)

  • Kim, Hee-Joung
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.2
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    • pp.83-87
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    • 2008
  • Diagnostic and functional imaging device have been developed independently. The recognition that combining of these two devices can provide better diagnostic outcomes by fusing anatomical and functional images. The representative examples of combining devices would be PET/CT and SPECT/CT. Development and their applications of animal imaging and instrumentation have been very active, as new drug development with advanced imaging device has been increased. The development of advanced imaging device resulted in researching and developing for detector technology and imaging systems. It also contributed to develop a new software, reconstruction algorithm, correction methods for physical factors, image quantitation, computer simulation, kinetic modeling, dosimetry, and correction for motion artifacts. Recently, development of MRI and PET by combining them together was reported. True integration of MRI and PET has been making the progress and their results were reported. The recent status of imaging and instrumentation in nuclear medicine is reported in this paper.

Comparison of Electron Beam Dosimetries by Means of Several Kinds of Dosimeters (수종의 측정기에 의한 전자선의 선량 측정의 비교)

  • Kang Wee-Saing
    • Radiation Oncology Journal
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    • v.7 no.1
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    • pp.93-100
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    • 1989
  • Several combinations of measuring devices and phantoms were studied to measure electron beams. Silicon Pmt junction diode was used to find the dependence of depth dose profile on field size on axis of electron beam Depths of 50, 80 and $90\%$ doses increased with the field size for small fields. For some larger fields, they were nearly constant. The smallest of field sizes over which the parameters were constant was enlarged with increase of the energy of electron beams. Depth dose distributions on axis of electron beam of $10\times10cm^2$ field were studied with several combinations of measuring devices and phantoms. Cylindrical ion chamber could not be used for measurement of surface dose, and was not convenient for measurement of near surface region of 6MeV electron. With some exceptions, parameters agreed well with those studied by different devices and phantoms. Surface dose in some energies showed $4\%$ difference between maximum and minimum. For 18MeV, depths of 80 and $90\%$ doses were considerably shallower by film than by others. Parallel-plate ion chamber with polystyrene phamtom and silicon PN junction would be recommended for measurement of central axis depth dose of electron beams with considerably large field size. It is desirable not to use cylindrical ion chamber for the purpose of measurement of surface dose or near surface region for lower energy electron beam. It is questionable that film would be recommended for measurement of dose distribution of electron with high energy like as 18MeV.

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Multi-tracer Imaging of a Compton Camera (다중 추적자 영상을 위한 컴프턴 카메라)

  • Kim, Soo Mee
    • Progress in Medical Physics
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    • v.26 no.1
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    • pp.18-27
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    • 2015
  • Since a Compton camera has high detection sensitivity due to electronic collimation and a good energy resolution, it is a potential imaging system for nuclear medicine. In this study, we investigated the feasibility of a Compton camera for multi-tracer imaging and proposed a rotating Compton camera to satisfy Orlov's condition for 3D imaging. Two software phantoms of 140 and 511 keV radiation sources were used for Monte-Carlo simulation and then the simulation data were reconstructed by listmode ordered subset expectation maximization to evaluate the capability of multi-tracer imaging in a Compton camera. And the Compton camera rotating around the object was proposed and tested with different rotation angle steps for improving the limited coverage of the fixed conventional Compton camera over the field-of-view in terms of histogram of angles in spherical coordinates. The simulation data showed the separate 140 and 511 keV images from simultaneous multi-tracer detection in both 2D and 3D imaging and the number of valid projection lines on the conical surfaces was inversely proportional to the decrease of rotation angle. Considering computation load and proper number of projection lines on the conical surface, the rotation angle of 30 degree was sufficient for 3D imaging of the Compton camera in terms of 26 min of computation time and 5 million of detected event number and the increased detection time can be solved with multiple Compton camera system. The Compton camera proposed in this study can be effective system for multi-tracer imaging and is a potential system for development of various disease diagnosis and therapy approaches.

Magnetic Resonance Elastography (자기 공명 탄성법)

  • Kim, Dong-Hyun;Yang, Jae-Won;Kim, Myeong-Jin
    • Investigative Magnetic Resonance Imaging
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    • v.11 no.1
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    • pp.10-19
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    • 2007
  • Conventional MRI methods using T1-, T2-, diffusion-, perfusion-weighting, and functional imaging rely on characterizing the physical and functional properties of the tissue. In this review, we introduce an imaging modality based on measured the mechanical properties of soft tissue, namely magnetic resonance elastography (MRE). The use of palpation to identify the stiffness of tissue remains a fundamental diagnostic tool. MRE can quantify the stiffness of the tissue thereby providing a objective means to measure the mechanical properties. To accomplish a successful clinical setting using MRE, hardware and software techniques in the area of transducer, pulse sequence, and imaging processing algorithm need to be developed. Transducer, a mechanical vibrator, is the core of MRE application to make wave propagate invivo. For this reason, considerations of the frame of human body, pressure and friction of the interface, and high magnetic field of a MRI system needs to be taken into account when designing a transducer. Given that the wave propagates through human body effectively, developing an appropriate pulse sequence is another important issue in obtaining an optimal image. In this review paper, we introduce the technical aspects needed for MRE experiments and introduce several applications of this new field.

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