• 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.

• Journal of Korean Neurosurgical Society
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• v.63 no.5
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• pp.649-656
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• 2020

Objective : Unclear mental state is one of the major factors contributing to diagnostic failure of occult skeletal trauma in patients with traumatic brain injury (TBI). The aim of this study was to evaluate the overlooked co-occurring skeletal trauma through whole body bone scan (WBBS) in TBI. Methods : A retrospective study of 547 TBI patients admitted between 2015 and 2017 was performed to investigate their cooccurring skeletal injuries detected by WBBS. The patients were divided into three groups based on the timing of suspecting skeletal trauma confirmed : 1) before WBBS (pre-WBBS); 2) after the routine WBBS (post-WBBS) with good mental state and no initial musculoskeletal complaints; and 3) after the routine WBBS with poor mental state (poor MS). The skeletal trauma detected by WBBS was classified into six skeletal categories : spine, upper and lower extremities, pelvis, chest wall, and clavicles. The skeletal injuries identified by WBBS were confirmed to be simple contusion or fractures by other imaging modalities such as X-ray or computed tomography (CT) scans. Of the six categorizations of skeletal trauma detected as hot uptake lesions in WBBS, the lesions of spine, upper and lower extremities were further statistically analyzed to calculate the incidence rates of actual fractures (AF) and actual surgery (AS) cases over the total number of hot uptake lesions in WBBS. Results : Of 547 patients with TBI, 112 patients (20.4 %) were presented with TBI alone. Four hundred and thirty-five patients with TBI had co-occurring skeletal injuries confirmed by WBBS. The incidences were as follows : chest wall (27.4%), spine (22.9%), lower extremities (20.2%), upper extremities (13.5%), pelvis (9.4%), and clavicles (6.3%). It is notable that relatively larger number of positive hot uptakes were observed in the groups of post-WBBS and poor MS. The percentage of post-WBBS group over the total hot uptake lesions in upper and lower extremities, and spines were 51.0%, 43.8%, and 41.7%, respectively, while their percentages of AS were 2.73%, 1.1%, and 0%, respectively. The percentages of poor MS group in the upper and lower extremities, and spines were 10.4%, 17.4%, and 7.8%, respectively, while their percentages of AS were 26.7%, 14.2%, and 11.1%, respectively. There was a statistical difference in the percentage of AS between the groups of post-WBBS and poor MS (p=0.000). Conclusion : WBBS is a potential diagnostic tool in understanding the skeletal conditions of patients with head injuries which may be undetected during the initial assessment.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2006.05a
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• pp.183-184
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• 2006

Some researchers proposed positive effects of whole body vibration (WBV) on osteoporotic trabecular bones of animals. In the present study, the correlation between the improvement of morphological characteristics and the effect of WBV was investigated and analyzed in OVX rats. The rats were randomly assigned to 5 groups: control, sham, WBV 17Hz, WBV 30Hz and WBV 45Hz. The WBV groups were exercised on a vibration platform (magnitude : $1mm_{peak-peak}$, frequency : 17Hz, 30Hz and 45Hz, 30 minutes/day for 5 days/week). The 4th lumbar on rats was scanned by In-vivo Micro-CT at the week 0(just before WBV) and the week 8(after WBV). Structural parameters of the 4th lumbar, based on two dimensional (2D) scan image data, were investigated and analyzed. The quantitative decrement rate of trabecular bone on WBV groups with 30Hz and 45Hz were lower than control and sham groups. The results showed the positive effect of WBV on osteoporotic bones of OVX rats.

• Proceedings of the Korean Society of Precision Engineering Conference
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• 2006.05a
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• pp.649-650
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• 2006

Some researchers proposed positive effects of whole body vibration (WBV) on osteoporotic trabecular bones of animals. In the present study, the correlation between the improvement of morphological characteristics and the effect of WBV was investigated and analyzed in OVX rats. The rats were randomly assigned to 5 groups: control, sham, WBV 17Hz, WBV 30Hz and WBV 45Hz. The WBV groups were exercised on a vibration platform (magnitude $1mm_{peak-peak}$, frequency : 17Hz, 30Hz and 45Hz, 30 minutes/day for 5 days/week). The 4th lumbar on rats was scanned by In-vivo Micro-CT at the week 0(iust before WBV) and the week 8(after WBV). Structural parameters of the 4th lumbar, based on two dimensional (2D) scan image data, were investigated and analyzed. The quantitative decrement rate of trabecular bone on WBV groups with 30Hz and 45Hz were lower than control and sham groups. The results showed the positive effect of WBV on osteoporotic bones of OVX rats.

• Korean Journal of Radiology
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• v.21 no.7
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• pp.891-899
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• 2020

Objective: To assess the diagnostic performance of a deep learning-based algorithm for automated detection of acute and chronic rib fractures on whole-body trauma CT. Materials and Methods: We retrospectively identified all whole-body trauma CT scans referred from the emergency department of our hospital from January to December 2018 (n = 511). Scans were categorized as positive (n = 159) or negative (n = 352) for rib fractures according to the clinically approved written CT reports, which served as the index test. The bone kernel series (1.5-mm slice thickness) served as an input for a detection prototype algorithm trained to detect both acute and chronic rib fractures based on a deep convolutional neural network. It had previously been trained on an independent sample from eight other institutions (n = 11455). Results: All CTs except one were successfully processed (510/511). The algorithm achieved a sensitivity of 87.4% and specificity of 91.5% on a per-examination level [per CT scan: rib fracture(s): yes/no]. There were 0.16 false-positives per examination (= 81/510). On a per-finding level, there were 587 true-positive findings (sensitivity: 65.7%) and 307 false-negatives. Furthermore, 97 true rib fractures were detected that were not mentioned in the written CT reports. A major factor associated with correct detection was displacement. Conclusion: We found good performance of a deep learning-based prototype algorithm detecting rib fractures on trauma CT on a per-examination level at a low rate of false-positives per case. A potential area for clinical application is its use as a screening tool to avoid false-negative radiology reports.

• Radiation Oncology Journal
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• v.3 no.2
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• pp.163-168
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• 1985

Intraocular melanoma is the most common primary occular malignancy in adult above the age of 20. Before treatment of intraocular melanoma, it is essential to do complete work-ups including LFT (LDH, SGPT), chest X-ray, whole body bone scan. Also, liver-spleen and brain scan will be done if clinically indicated. Though, malignant melanoma is radioresistant, however, show rapid tumor shrinkage after irradiation with total tumor dose of 7,000 to 8,000 rads in 7-8 weeks.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.1
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• pp.79-82
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• 2009

A 73-year-old man presented with a chief complaint of progressive left knee pain for two months. He had a history of total thyroidectomy and central lymph node dissection due to papillary thyroid carcinoma three months ago. MRI images revealed a solid mass in the left patella. A solid mass demonstrated low signal on T1 weighed image, and high signal on T2 weighed image. And whole body bone scan showed focal photon defect in same lesion of left patella. The histologic result of left knee lesion was adenocarcinoma, consistent with metastatic papillary thyroid carcinoma. Although patellar metastasis of papillary thyroid carcinoma is very rare, when knee pain and radiologic abnormality are noted, differential diagnosis of metastasis is necessary.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.24-30
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• 2009

Purpose: Today, Prostate cancer has been gradually increasing, according to the change of internal incidence rate of cancer. Generally, prostate cancer has lead to dead over 90%, in case of metastasis of lymph node and bone. So, innovative development of new radiopharmaceutical and imaging modality is progressed for detection of that metastasis, in nuclear medicine, now. Therefore, this study shows the usefulness of $^{18}F$-Fluoride PET/CT improved diagnosability on bone metastasis of prostate cancer. Materials and Methods: In this study, 33 male patients with prostate cancer were examined (The mean age: $67.8{\pm}10.2$ years old). Every patient was done each whole body bone scan (WBBS) and $^{18}F$-Fluoride positron emission tomography/computed tomography ($^{18}F$-Fluoride PET/CT). And then, using Receiver Operating Characteristic Curve (ROC curve), each sensitivity and specificity of two modalities was measured and compared with. Results: In 22 patients (66.6%) of all, bone metastasis was detected. And, in WBBS, sensitivity was 63.6%, specificity, 81.8%; in $^{18}F$-Fluoride PET/CT, sensitivity was 100% and specificity was 90.9%. As a result of ROC curve, AUROC (The Area under an ROC) of WBBS was 0.778, and that of $^{18}F$-Fluoride PET/CT, 0.942. Conclusions: $^{18}F$-Fluoride PET/CT was higher both sensitivity and specificity than WBBS, and it was valuable to detect bone metastasis of prostate cancer more definitely, with 3D imaging realization. Also, in $^{18}F$-Fluoride PET/CT, physiological images were acquired in more short time than WBBS, so, it was possible to reduce patient's waiting time and complaint. Therefore, it is considered that $^{18}F$-Fluoride PET/CT is able to improve diagnosability by offering more accurate images, as cuts in a share of high cost.

• Imaging Science in Dentistry
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• v.44 no.4
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• pp.263-271
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• 2014

Purpose: This study aimed to evaluate the use of dental cone-beam computed tomography (CBCT) in the diagnosis of osteoporosis among menopausal and postmenopausal women by using only a CBCT viewer program. Materials and Methods: Thirty-eight menopausal and postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) examination for hip and lumbar vertebrae were scanned using CBCT (field of view: $13cm{\times}15cm;$ voxel size: 0.25 mm). Slices from the body of the mandible as well as the ramus were selected and some CBCT-derived variables, such as radiographic density (RD) as gray values, were calculated as gray values. Pearson's correlation, one-way analysis of variance (ANOVA), and accuracy (sensitivity and specificity) evaluation based on linear and logistic regression were performed to choose the variable that best correlated with the lumbar and femoral neck T-scores. Results: RD of the whole bone area of the mandible was the variable that best correlated with and predicted both the femoral neck and the lumbar vertebrae T-scores; further, Pearson's correlation coefficients were 0.5/0.6 (p value=0.037/0.009). The sensitivity, specificity, and accuracy based on the logistic regression were 50%, 88.9%, and 78.4%, respectively, for the femoral neck, and 46.2%, 91.3%, and 75%, respectively, for the lumbar vertebrae. Conclusion: Lumbar vertebrae and femoral neck osteoporosis can be predicted with high accuracy from the RD value of the body of the mandible by using a CBCT viewer program.

• The Journal of the Korea Contents Association
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• v.11 no.10
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• pp.488-493
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• 2011

The Korean spine geometry and property data for researchers were made by KISTI and Catholic Institute for Applied Anatomy. We took whole spine CT, X-Ray, BMD scan for making high resolution cross-sectional spine images using more 20 donated cadavers(60 - 80 years). Then we constructed 3-dimensional volume model using serial CT images by Mimics software. The major morphometric parameters of vertebrae were measured. Mechanical motion and property data were obtained by the same cadavers using the DEXA for BMD and the spine simulator. The Korean spine geometry and property data could be used for research and development of medical device.