• Nuclear Medicine and Molecular Imaging
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• v.41 no.1
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• pp.30-41
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• 2007

Purpose: Bone metastasis in breast cancer patients are usually assessed by conventional Tc-99m methylene diphosphonate whole-body bone scan, which has a high sensitivity but a poor specificity. However, positron emission tomography with $^{18}F-2-deoxyglucose$ (FDG-PET) can offer superior spatial resolution and improved specificity. FDG-PET/CT can offer more information to assess bone metastasis than PET alone, by giving a anatomical information of non-enhanced CT image. We attempted to evaluate the usefulness of FDG-PET/CT for detecting bone metastasis in breast cancer and to compare FDG-PET/CT results with bone scan findings. Materials and Methods: The study group comprised 157 women patients (range: $28{\sim}78$ years old, $mean{\pm}SD=49.5{\pm}8.5$) with biopsy-proven breast cancer who underwent bone scan and FDG-PET/CT within 1 week interval. The final diagnosis of bone metastasis was established by histopathological findings, radiological correlation, or clinical follow-up. Bone scan was acquired over 4 hours after administration of 740 MBq Tc-99m MDP. Bone scan image was interpreted as normal, low, intermediate or high probability for osseous metastasis. FDG PET/CT was performed after 6 hours fasting. 370 MBq F-18 FDG was administered intravenously 1 hour before imaging. PET data was obtained by 3D mode and CT data, used as transmission correction database, was acquired during shallow respiration. PET images were evaluated by visual interpretation, and quantification of FDG accumulation in bone lesion was performed by maximal SUV(SUVmax) and relative SUV(SUVrel). Results: Six patients(4.4%) showed metastatic bone lesions. Four(66.6%) of 6 patients with osseous metastasis was detected by bone scan and all 6 patients(100%) were detected by PET/CT. A total of 135 bone lesions found on either FDG-PET or bone scan were consist of 108 osseous metastatic lesion and 27 benign bone lesions. Osseous metastatic lesion had higher SUVmax and SUVrel compared to benign bone lesion($4.79{\pm}3.32$ vs $1.45{\pm}0.44$, p=0.000, $3.08{\pm}2.85$ vs $0.30{\pm}0.43$, p=0.000). Among 108 osseous metastatic lesions, 76 lesions showed as abnormal uptake on bone scan, and 76 lesions also showed as increased FDG uptake on PET/CT scan. There was good agreement between FDG uptake and abnormal bone scan finding (Kendall tau-b : 0.689, p=0.000). Lesion showed increased bone tracer uptake had higher SUVmax and SUVrel compared to lesion showed no abnormal bone scan finding ($6.03{\pm}3.12$ vs $1.09{\pm}1.49$, p=0.000, $4.76{\pm}3.31$ vs $1.29{\pm}0.92$, p=0.000). The order of frequency of osseous metastatic site was vertebra, pelvis, rib, skull, sternum, scapula, femur, clavicle, and humerus. Metastatic lesion on skull had highest SUVmax and metastatic lesion on rib had highest SUVrel. Osteosclerotic metastatic lesion had lowest SUVmax and SUVrel. Conclusion: These results suggest that FDG-PET/CT is more sensitive to detect breast cancer patients with osseous metastasis. CT scan must be reviewed cautiously skeleton with bone window, because osteosclerotic metastatic lesion did not showed abnormal FDG accumulation frequently.

• The Journal of Korean Society for Radiation Therapy
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• v.24 no.2
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• pp.123-135
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• 2012

Purpose: It is essential to minimize the movement of tumor due to respiratory movement at the time of respiration controlled radiotherapy of non-small cell lung cancer patient. Accordingly, this Study aims to evaluate the usefulness of restricted respiratory period by comparing and analyzing the treatment plans that apply free and restricted respiration period respectively. Materials and Methods: After having conducted training on 9 non-small cell lung cancer patients (tumor n=10) from April to December 2011 by using 'signal monitored-breathing (guided- breathing)' method for the 'free respiratory period' measured on the basis of the regular respiratory period of the patents and 'restricted respiratory period' that was intentionally reduced, total of 10 CT images for each of the respiration phases were acquired by carrying out 4D CT for treatment planning purpose by using RPM and 4-dimensional computed tomography simulator. Visual gross tumor volume (GTV) and internal target volume (ITV) that each of the observer 1 and observer 2 has set were measured and compared on the CT image of each respiratory interval. Moreover, the amplitude of movement of tumor was measured by measuring the center of mass (COM) at the phase of 0% which is the end-inspiration (EI) and at the phase of 50% which is the end-exhalation (EE). In addition, both observers established treatment plan that applied the 2 respiratory periods, and mean dose to normal lung (MDTNL) was compared and analyzed through dose-volume histogram (DVH). Moreover, normal tissue complication probability (NTCP) of the normal lung volume was compared by using dose-volume histogram analysis program (DVH analyzer v.1) and statistical analysis was performed in order to carry out quantitative evaluation of the measured data. Results: As the result of the analysis of the treatment plan that applied the 'restricted respiratory period' of the observer 1 and observer 2, there was reduction rate of 38.75% in the 3-dimensional direction movement of the tumor in comparison to the 'free respiratory period' in the case of the observer 1, while there reduction rate was 41.10% in the case of the observer 2. The results of measurement and comparison of the volumes, GTV and ITV, there was reduction rate of $14.96{\pm}9.44%$ for observer 1 and $19.86{\pm}10.62%$ for observer 2 in the case of GTV, while there was reduction rate of $8.91{\pm}5.91%$ for observer 1 and $15.52{\pm}9.01%$ for observer 2 in the case of ITV. The results of analysis and comparison of MDTNL and NTCP illustrated the reduction rate of MDTNL $3.98{\pm}5.62%$ for observer 1 and $7.62{\pm}10.29%$ for observer 2 in the case of MDTNL, while there was reduction rate of $21.70{\pm}28.27%$ for observer 1 and $37.83{\pm}49.93%$ for observer 2 in the case of NTCP. In addition, the results of analysis of correlation between the resultant values of the 2 observers, while there was significant difference between the observers for the 'free respiratory period', there was no significantly different reduction rates between the observers for 'restricted respiratory period. Conclusion: It was possible to verify the usefulness and appropriateness of 'restricted respiratory period' at the time of respiration controlled radiotherapy on non-small cell lung cancer patient as the treatment plan that applied 'restricted respiratory period' illustrated relative reduction in the evaluation factors in comparison to the 'free respiratory period.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.4
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• pp.291-298
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• 2007

Purpose: To investigate the feasibility of TI-201 SPECT with intra coronary injection (lC-I) in the detection of viable myocardium, we have performed SPECT imaging after direct intracoronary injection of TI-201 and images were compared with those of stress-reinjection (Re-I) SPECT. Methods: Fourteen coronary artery disease patients (male 11, mean age 54 years) who had myocardial infarction or demonstrated left ventricular wall motion abnormality on echocardiography were enrolled. Three mCi of TI-201 was injected into both coronary arteries during angiography and images were acquired between 6- and 24-hour after injection. Reinjection imaging with 1 mCi of TI-201 was performed at 4-hour after adenosine stress imaging with 3 mCi of TI-201. Images were interpreted according to 4-grade visual scoring system (grade 0-3). Segments with mild to moderated uptake (${\leq}$grade 1), and upgraded more than one score with reinjection, and were defined as viable myocardium. Results: Image quality was poor in two cases with IC-I. Numbers of non-viable segments were 60 (23.8%) with IC-I, and 38 (15.1%) with Re-I, respectively. Overall agreement for perfusion grade per myocardial segment in each IC-I and Re-I was 76.5%. Overall agreement for viable segment between IC-I and Re-I was 90.5%. Only one out of 38 segments interpreted as non-viable with Re-I were interpretated as viable with IC-I. And 23 out of 214 segments interpreted as viable with Re-I were interpreted as non-viable with IC-I. Conclusion: Intracoronary TI-201 SPECT seemed to be not advantageous over stress-rest reinjection imaging in the assessment of myocardial viability, mainly due to low count statistics at 6-hour or 24-hour delayed time points. The feasibility of intracoronary TI- 201 SPECT is considered to be limited.

• Journal of the Daesoon Academy of Sciences
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• v.35
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• pp.217-253
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• 2020

This study analyzes the principles of the 'Earthly Paradise' (仙境, the realm of immortals), 'Virtuous Concordance of Yin and Yang' (陰陽合德), and the 'Reordering Works of Heaven and Earth' (天地公事) while combining them with Joseon art. Therefore, this study aims to discover the context wherein the concept of Taiji in 'Daesoon Truth,' deeply penetrates into Joseon art. Doing so reveals how 'Daesoon Thought' is embedded in the lives and customs of the Korean people. In addition, this study follows a review of the sentiments and intellectual traditions of the Korean people based on 'Daesoon Thought' and creative works. Moreover, 'Daesoon Thought' brings all of this to the forefront in academics and art at the cosmological level. The purpose of this research is to vividly reveal the core of 'Daesoon Thought' as a visual image. Through this, the combination of 'Daesoon Thought' and Joseon art will secure both data and reality at the same time. As part of this, this study deals with the world of 'Daesoon Thought' as a cosmological Taiji principle. This concept is revealed in Joseon art, which is analyzed and examined from the viewpoint of art philosophy. First, as a way to make use of 'Daesoon Thought,' 'Daesoon Truth' was developed and directly applied to Joseon art. In this way, reflections on Korean life within 'Daesoon Thought' can be revealed. In this regard, the selection of Joseon art used in this study highlights creative works that have been deeply ingrained into people's lives. For example, as 'Daesoon Thought' appears to focus on the genre painting, folk painting, and landscape painting of the Joseon Dynasty, attention is given to verifying these cases. This study analyzes 'Daesoon Thought,' which borrows from Joseon art, from the perspective of art philosophy. Accordingly, attempts are made to find examples of the 'Virtuous Concordance of Yin and Yang' and Tai-Ji in Joseon art which became a basis by which 'Daesoon Thought' was communicated to people. In addition, appreciating 'Daesoon Thought' in Joseon art is an opportunity to vividly examine not only the Joseon art style but also the life, consciousness, and mental world of the Korean people. As part of this, Chapter 2 made several findings related to the formation of 'Daesoon Thought.' In Chapter 3, the structures of the ideas of 'Earthly Paradise' and 'Virtuous Concordance of Yin and Yang' were likewise found to have support. And 'The Reordering Works of Heaven and Earth' and Tai-Ji were found in depictions of metaphysical laws. To this end, the laws of 'The Reordering Works of Heaven and Earth' and the structure of Tai-Ji were combined. In chapter 4, we analyzed the 'Daesoon Thought' in the life and work of the Korean people at the level of the convergence of 'Daeesoon Thought' and Joseon art. The analysis of works provides a glimpse into the precise identity of 'Daesoon Thought' as observable in Joseon art, as doing so is useful for generating empirical data. For example, works such as Tai-Jido, Ssanggeum Daemu, Jusachaebujeokdo, Hwajogi Myeonghwabundo, and Gyeongdodo are objects that inspired descriptions of 'Earthly Paradise', 'Virtuous Concordance of Yin and Yang,' and 'The Reordering Works of Heaven and Earth.' As a result, Tai-Ji which appears in 'Daesoon Thought', proved the status of people in Joseon art. Given all of these statements, the Tai-Ji idea pursued by Daesoon Thought is a providence that follows change as all things are mutually created. In other words, it was derived that Tai-Ji ideology sits profoundly in the lives of the Korean people and responds mutually to the providence that converges with 'Mutual Beneficence.'