• Korean Journal of Radiology
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• v.20 no.1
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• pp.126-133
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• 2019

Objective: To compare the lumbar vertebral bone marrow fat-signal fractions obtained from six-echo modified Dixon sequence (6-echo m-Dixon) with those from single-voxel magnetic resonance spectroscopy (MRS) in patients with low back pain. Materials and Methods: Vertebral bone marrow fat-signal fractions were quantified by 6-echo m-Dixon (repetition time [TR] = 7.2 ms, echo time (TE) = 1.21 ms, echo spacing = 1.1 ms, total imaging time = 50 seconds) and single-voxel MRS measurements in 25 targets (23 normal bone marrows, two focal lesions) from 24 patients. The point-resolved spectroscopy sequence was used for localized single-voxel MRS (TR = 3000 ms, TE = 35 ms, total scan time = 1 minute 42 seconds). A 2 × 2 × 1.5 cm³ voxel was placed within the normal L2 or L3 vertebral body, or other lesions including a compression fracture or metastasis. The bone marrow fat spectrum was characterized on the basis of the magnitude of measurable fat peaks and a priori knowledge of the chemical structure of triglycerides. The imaging-based fat-signal fraction results were then compared to the MRS-based results. Results: There was a strong correlation between m-Dixon and MRS-based fat-signal fractions (slope = 0.86, R² = 0.88, p < 0.001). In Bland-Altman analysis, 92.0% (23/25) of the data points were within the limits of agreement. Bland-Altman plots revealed a slight but systematic error in the m-Dixon based fat-signal fraction, which showed a prevailing overestimation of small fat-signal fractions (< 20%) and underestimation of high fat-signal fractions (> 20%). Conclusion: Given its excellent agreement with single-voxel-MRS, 6-echo m-Dixon can be used for visual and quantitative evaluation of vertebral bone marrow fat in daily practice.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.133-137
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• 2010

Purpose: Breast cancer is known to be more vulnerable to bone metastasis and lymph node metastasis than other types of cancer, and nuclear examinations whole body bone scan and lymphoscintigraphy are performed commonly before and after breast cancer operation. In case whole body bone scan is performed on the day before lymphoscintigraphy, the radiopharmaceutical taken into and remaining in the bones provides anatomical information for tracking and locating sentinel lymph nodes. Thus, this study purposed to examine how much bone density affects in locating sentinel lymph nodes. Materials and Methods: The subjects of this study were 22 patients (average age $52{\pm}7.2$) who had whole body bone scan and lymphoscintigraphy over two days in our hospital during the period from January to December, 2009. In the blind test, 22 patients (average age $57{\pm}6.5$) who had lymphoscintigraphy using $^{57}Co$ flood phantom were used as a control group. In quantitative analysis, the relative ratio of the background to sentinel lymph nodes was measured by drawing ROIs on sentinel lymph nodes and the background, and in gross examination, each of a nuclear physician and a radiological technologist with five years' or longer field experience examined images through blind test in a five-point scale. Results: In the results of quantitative analysis, the relative ratio of the background to sentinel lymph nodes was 14.2:1 maximum and 8.5:1 ($SD{\pm}3.48$) on the average on the front, and 14.7:1 maximum and 8.5:1 ($SD{\pm}3.42$) on the average on the side. In the results of gross examination, when $^{57}Co$ flood phantom images were compared with images containing bones, the score was relative high as 3.86 ($SD{\pm}0.35$) point for $^{57}Co$ flood phantom images and 4.09 ($SD{\pm}0.42$) for bone images. Conclusion: When whole body bone scan was performed on the day before lymphoscintigraphy, the ratio of the background to sentinel lymph nodes was over 10:1, so there was no problem in locating lymph nodes. In addition, we expect to reduce examination procedures and improve the quality of images by indicating the location of sentinel lymph nodes using bone images as body contour without the use of a source.

• Journal of Korean Clinical Health Science
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• v.2 no.2
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• pp.133-147
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• 2014

Purpose. Radiation therapy for oncologic emergencies is an important modality in the management of cancer patients. The aim of the present study was to review the roles of RT in oncologic emergencies based on literature review. Methods. The oncologic emergencies requiring rapid treatment include superior vena cava syndrome, spinal cord compression, brain metastasis, and bone metastasis. We reviewed the literatures on the pathophysiology, diagnosis, and treatment of oncologic emergencies. Results. In this literature review, radiation therapy among treatment modalities for oncologic emergencies has been shown to be fast and very effective treatment modality for oncologic emergencies. Conclusions. Based on this review, we conclude that the literature provides support for the role of radiation therapy in the situation of oncologic emergencies. As the number of cancer patients increase, the prevalence of oncologic emergencies will increase. In the future, the development of RT techniques will provide the improvement of not only patient's quality of life but also the survival.

• The Journal of the Korean bone and joint tumor society
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• v.5 no.1
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• pp.63-69
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• 1999

Recently we experienced four cases of soft tissue Ewing sarcoma, developed in the calf muscles in two cases, and one case each in the foot and suprascapular region. We also found that the clinical course in all cases was rather rapid, because of local recurrence and metastatic lesions developing within a few months, followed by the patients' death in about 2 years after the primary tumor was excised. These cases were improperly treated initially as some kind of benign soft tissue tumor. The delay led to missed early accurate diagnosis and was thought to be one of the main causes for the rapid local recurrence and metastasis after tumor excision. The pulmonary metastasis was the most common cause of death.

• The Journal of the Korean bone and joint tumor society
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• v.15 no.2
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• pp.171-177
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• 2009

Low grade central osteosarcoma is an rare variant of conventional osteosarcoma and generally occurs in older age than conventional. We experienced a case of low grade osteosarcoma occurred in a 12 years old female. Moreover, it occurred multifocally in left tibia, left femoral neck and midshaft, and left acetabulum. We could not sure whether it was from synchronous or metachronous metastasis. Usually the low grade osteosarcoma progresses very slowly. But, despite this case was low grade osteosarcoma with very indolent progression, furthermore, it showed synchronous or metachronous metastasis. So we report this unusual case with review of literature.

• The Journal of the Korean bone and joint tumor society
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• v.1 no.2
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• pp.233-239
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• 1995

Hemangiopericytoma is a rare tumor of blood vessels, first described and named by Stout and Murray in 1942, arising from the contractile, elongated cells which surround capillaries originated from the pericytes of Zimmermann. It can develop anywhere there are capillaries and mostly in the connective tissue of the human body. It can also develop at any age from 12 to 90 years old, and the rate of metastasis and prognosis vary with its histologic finding, We report three cases of hemangiopericytoma - one recurred in the right forearm where a tumor was excised 15 years ago, another occurred in the left pubis which metastasized to lung and head, the other metastasized from the lung to the right scapular area - treated at the department of orthopaedic surgery, Hanyang University Hospital from 1989 to 1995.

• Journal of Korean Neurosurgical Society
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• v.29 no.8
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• pp.1069-1073
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• 2000

Although the most commonly encountered orbital tumor is metastatic tumor, adenocarcinoma of stomach metastasized to the optic nerve is rarely reported. The authors discuss a rare case of metastatic adenocarcinoma of left optic nerve with a review of literature. A 44-year-old man presented with decreased visual acuity of left eye for 3 months. Neurologic examination revealed left optic neuropathy. On MR imaging, a homogenously wellenhanced mass surrounding left optic nerve around optic canal was noticed. The X-rays and the whole body bone scan sho-wed multiple bony metastasis. Subtotal removal was performed via combined subfrontal and pterional approach and metastatic adenocarcinoma from the stomach was confirmed histologically. Postoperative course was uneventful, but there was no improvement of visual acuity.

• Journal of Korean Neurosurgical Society
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• v.54 no.3
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• pp.246-249
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• 2013

A solitary fibrous tumor (SFT) is a rare neoplasm originated from the pleura, but they can occur in a variety of extrathoracic regions. Although many cases of primary SFT have been reported, there are extremely rare repots to date of a malignant SFT in the spine or skull. A 54-year-woman visited our hospital due to low back pain and both leg radiating pain. Several imaging studies including magnetic resonance imaging and computed tomography revealed expansive enhanced lesions in the occipital bone, T8, S1-2, and ilium, with neural tissue compression. We performed surgical resection of the tumor in each site, and postoperative radiosurgery and chemotherapy were performed. However, after six months, tumors were recurred and metastasized in multiple regions including whole spine and lung. The authors report here the first case of patient with malignant SFT of tandem lesions in the various bony structures, including skull, thoracic spine, and sacral spine, with a rapid recurrence and metastasis. Although malignant SFT is extremely rare, it should be considered in the differential diagnosis and carful follow-up is needed.

• The Korean Journal of Pain
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• v.21 no.3
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• pp.229-232
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• 2008

Insufficiency fractures of the sacrum are relatively common and cause severe low back and buttock pain. Percutaneous vertebroplasty is effective for treating vertebral compression fractures. We present a case of percutaneous sacroplasty for the treatment of low back and buttock pain in a sacral insufficiency fracture. A 79-year-old male with non-small lung cancer presented with severe low back and buttock pain after series of radiation treatments. Preoperative MRI showed both a sacral ala and S2 metastatic insufficiency fracture. An epidural port was inserted for continuous morphine infusion and sacral nerve root blocks were performed. However, his pain did not diminish and we attempted percutaneous sacroplasty. Both sides of the sacroplasty were done with a fluoroscopy-guided technique with 1.7 ml and 2.3 ml of bone cement injected into the right and left sacral ala. Pain relief was significant and the patient was able to sit down 1 day after the procedure.

• Journal of Korean Neurosurgical Society
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• v.45 no.2
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• pp.107-111
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• 2009

Meningiomas are usually benign neoplasms in which extracranial metastases occur very rarely. We report a case of multiple extracranial metastases of an atypical meningioma following a local recurrence. A 68-year-old man presented with left-side motor weakness and dysarthria for two weeks. A computed tomography (CT) scan and magnetic resonance imaging (MRI) showed an intraventricular tumor. We performed a total mass removal, and the histopathologic findings were consistent with benign meningioma. Eight months later, the meningioma recurred. We performed a reoperation and whole brain radiation therapy postoperatively. The histopathologic findings showed atypical meningioma. Six months later, CT and MRI revealed metastases to multiple vertebrae, lung, ribs and perirenal soft tissue so a decompressive laminectomy with mass removal was performed. The histopathologic findings of the spinal tumors showed atypical meningioma. The results from perirenal biopsies were consistent with metastatic meningioma. In conclusion, extracranial metastasis as well as local recurrence must be considered in atypical or anaplastic meningioma. There must be regular follow-ups. Finally, an evaluation of the chest, abdomen and bone is necessary, especially when related symptoms or signs develop.