• Journal of Yeungnam Medical Science
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• 제34권2호
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• pp.279-284
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• 2017

Pulmonary artery sarcoma (PAS) is a rare and fatal disease that often mimics chronic thromboembolic pulmonary hypertension (CTEPH); therefore, diagnosis of PAS is often delayed. Herein, a healthy 74-year-old man was presented with a 4-month history of dyspnea. Chest computed tomography showed wall thickening and stenosis in the main pulmonary artery as well as in both proximal pulmonary arteries. In order to differentiate between unusual CTEPH, vasculitis, and PAS, we performed right heart catheterization and pulmonary angiography. The mean pulmonary arterial pressure was 21 mmHg, and there was severe pulmonary artery stenosis. Thrombi on the pulmonary arterial wall lesions were observed in intravascular ultrasound and optical coherence tomography. Furthermore, the patient had a history of deep vein thrombosis. Therefore, we diagnosed unusual CTEPH. After 6 months of rivaroxaban anticoagulation therapy, a chest X-ray revealed a left lower lobe lung mass, and a positron emission tomography later showed hypermetabolic lesions in the main pulmonary artery wall, in both pulmonary arteries walls, in the lung parenchyma, and in the bones. A biopsy of the right proximal humerus lesion revealed undifferentiated intimal sarcoma. Pulmonary sarcoma is rare, but should be considered when differentially diagnosing main pulmonary artery wall thickening and stenosis. A positron emission tomography may aid in this diagnosis.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.985-989
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• 2012

Objective: To make sure the feasibility with $^{18F}FDG$ PET/CT to guided dynamic intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma patients, by dosimetric verification before treatment. Methods: Chose 11 patients in III~IVA nasopharyngeal carcinoma treated with functional image-guided IMRT and absolute and relative dosimetric verification by Varian 23EX LA, ionization chamber, 2DICA of I'mRT Matrixx and IBA detachable phantom. Drawing outline and making treatment plan were by different imaging techniques (CT and $^{18F}FDG$ PET/CT). The dose distributions of the various regional were realized by SMART. Results: The absolute mean errors of interest area were $2.39%{\pm}0.66$ using 0.6cc ice chamber. Results using DTA method, the average relative dose measurements within our protocol (3%, 3 mm) were 87.64% at 300 MU/min in all filed. Conclusions: Dosimetric verification before IMRT is obligatory and necessary. Ionization chamber and 2DICA of I'mRT Matrixx was the effective dosimetric verification tool for primary focal hyper metabolism in functional image-guided dynamic IMRT for nasopharyngeal carcinoma. Our preliminary evidence indicates that functional image-guided dynamic IMRT is feasible.

• 대한방사선기술학회지:방사선기술과학
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• 제29권4호
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• pp.257-260
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• 2006

전신 PET/CT 검사에서 $^{18}F-FDG$의 방사성의약품을 투여한 환자가 방사선원이 되기에 환자로부터 종사자의 피폭선량 예측을 위한 PET 검사실에서 환자 주변의 공간선량률을 측정 분석하였다. 연간 개인피폭선량은 대학병원의 핵의학 분야에 근무하는 종사자가 방사선종양학과와 소규모병원의 진단방사선 분야에 비해 검사 중에 환자로부터 방출되는 공간선량률에 의하여 개인피폭선량이 높게 나타났다. 그리고 PET/CT 검사에서 $^{18}F-FDG$를 이용하는 경우에 $^{99m}Tc$ 보다 공간선량률이 $4{\sim}6$배 정도로 훨씬 높고, 촬영실 전체에 공간선량률이 분포함을 알 수 있었다. 따라서 방사성의약품 투여 후 안정실이나 PET 검사 중에 촬영실 내에서는 항상 방사선 방어의 기본인 시간은 짧게, 거리는 멀리, 차폐를 고려하여 PET 검사를 수행하는 것이 매우 중요하고, 환자로부터의 공간선량률에 따른 종사자의 개인피폭선량을 줄이기 위한 최선의 노력이 필요하다.

• 한국컴퓨터정보학회논문지
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• 제12권2호
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• pp.123-130
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• 2007

본 논문에서는 소동물 생체내 실험시 서로 다른 장비에서 획득된 영상의 융합 및 정합을 위한 방법을 제안한다. 마우스의 꼬리 정맥에 $[[^{18}F]FDG$를 주사하여 60분 섭취후 서로 다른 장비에서 동일한 위치의 영상을 획득하기 위하여 아크릴 재질의 소동물 가이드에 기준마크를 설정하고 microPET과 CT 영상을 획득하였다. MicroPET으로 획득된 리스트모드(list-mode) 데이터는 Fourier Rebinning(FRB) 방법을 사용하여 사이노그램(Sinogram)으로 변환 후 4 번의 반복횟수를 가지는 Ordered Subset Expectation Maximization(OSEM) 알고리즘으로 재구성하였다. MicroPET 영상획득후 PET/CT의 CT를 이용하여 CT영상을 획득하였다. MicroPET 영상에서 폐영역을 정확히 찾아내는 어려움이 있어. 해부학적 정보를 제공하는 CT 영상을 이용하여 폐 영역을 구분하였다. 영상 융합을 위한 불일치 부분을 해결하기 위하여 기준마크의 정보와 폐 영역의 정보를 이용하여 회전과 이동정보를 가지는 어파인 (affine) 변환 행렬 구하여 영상 정합에 사용하였다. 이 방법은 정량적 정확성과 영상 해석의 정확성을 개선할 것으로 기대된다.

• 대한방사성의약품학회지
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• 제1권2호
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• pp.130-136
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• 2015

We evaluate the influence of MR contrast agent on positron emission tomography (PET) image using phantom, animal and human studies. Phantom consisted of 15 solutions with the mixture of various concentrations of Gd-based MR contrast agent and fixed activity of [$^{18}F$]FDG. Animal study was performed using rabbit and two kinds of MR contrast agents. After injecting contrast agent, CT or MRI scanning was performed at 1, 2, 5, 10, and 20 minutes. PET image was obtained using clinical PET/CT scan, and attenuation correction was performed using the all CT images. The values of HU, PET activity and MRI intensity were obtained from ROIs in each phantom and organ regions. In clinical study, patients (n=20) with breast cancer underwent sequential acquisitions of early [$^{18}F$]FDG PET/CT, MRI and delayed PET/CT. In phantom study, as the concentration increased, the CT attenuation and PET activity also increased. However, there was no relationship between the PET activity and the concentration in the clinical dose range of contrast agent. In animal study, change of PET activity was not significant at all time point of CT scan both MR contrast agents. There was no significant change of HU between early and delayed CT, except for kidney. Early and delayed SUV in tumor and liver showed significant increase and decrease, respectively (P<0.05). Under the condition of most clinical study (< 0.2 mM), MR contrast agent did not influence on PET image quantitation.

• 방사선산업학회지
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• 제11권1호
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• pp.19-25
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• 2017

It is suggested that the dose limit recommended in the Enforcement Decree of Korea's Nuclear Safety Act should not exceed 150 mSv per year for radiation workers. Recently, however, ICRP 118 report has suggested that the threshold dose of the lens should be reduced to 0.2~0.5 Gy and the mean dose should not exceed 50 mSv per year for an average of 20 mSv over 5 years. Based on these contents, $^{123}I$, $^{99m}Tc$, and $^{18}F-FDG$, which are radioisotope drugs that are used directly by radiation workers in the nuclear medicine department in Korea are expected to receive a large dose of radiation in the lens in distribution and injection jobs to administer them to patients. The ED3 Active Extremity Dosimeter was used to measure the dose of the lens in the nuclear medicine and radiation workers and how much of the dose was received per 1 mCi.

• 핵의학기술
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• 제27권1호
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• pp.62-65
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• 2023

Purpose The purpose of this study is to determine whether the glucose loading method (GLM) is useful in the differentiation of cerebral gliomas by comparing it with fasting images. Materials and Methods The patients were 70 people diagnosed with cerebral gliomas, and the equipment was Discovery 710 (GE Healthcare, MI, USA). All patients fasted for more than 6 hours, and fasting images and GLM were performed under the same imaging conditions, and the examination interval was 1 to 14 days. GLM administered 250 ㎖ of 10% glucose solution prior to radiopharmaceutical injection. SUVmax of cerebral glioma and SUVmean of cerebral cortex were measured and then compared and analyzed by tumor-to-normal brain cortex ratio (TNR). Statistical analysis confirmed the difference between the two images with an independent-sample t-test. Results The averages of GLM and fasting TNR were 1.26 and 1.09, respectively, which were 15.6% higher in GLM. In low-grade, the difference in TNR was insignificant at 4%, but in high-grade, 23%, GLM was high. There was a statistically significant difference between the two images (P=0.008), but there was no statistically significant difference in TNR in the low grade (P=0.473), and there was a very significant difference in the high grade (P=0.005). Conclusion GLM increased TNR for cerebral gliomas. In particular, it was found that the TNR increased more in the high grade. Therefore, GLM is considered to be useful for the differentiation of high-grade gliomas.

• 한국컴퓨터정보학회:학술대회논문집
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• 한국컴퓨터정보학회 2023년도 제68차 하계학술대회논문집 31권2호
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• pp.179-181
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• 2023

본 논문에서는 GAN 기반의 영상 생성 방법론을 이용해 delayed PET 영상을 생성하는 연구를 수행하였다. PET은 양전자를 방출하는 방사성 동위원소를 표지한 방사성의약품의 체내 분포를 시각화함으로서 암 세포 진단에 이용되는 의료영상 기법이다. 하지만 PET의 스캔 과정에서 방사성의약품이 체내에 분포하는 데에 걸리는 시간이 오래 걸린다는 문제점이 존재한다. 따라서 본 연구에서는 방사성의약품이 충분히 분포되지 않은 상태에서 얻은 PET 영상을 통해 목표로 하는 충분히 시간이 지난 후에 얻은 PET 영상을 생성하는 모델을 GAN (generative adversarial network)에 기반한 image-to-image translation(I2I)를 통해 수행했다. 특히, 생성 전후의 영상 간의 영상 쌍을 고려한 paired I2I인 Pix2pix와 이를 고려하지 않은 unpaired I2I인 CycleGAN 두 가지의 방법론을 비교하였다. 연구 결과, Pix2pix에 기반해 생성한 delayed PET 영상이 CycleGAN을 통해 생성한 영상에 비해 영상 품질이 좋음을 확인했으며, 또한 실제 획득한 ground-truth delayed PET 영상과의 유사도 또한 더 높음을 확인할 수 있었다. 결과적으로, 딥러닝에 기반해 early PET을 통해 delayed PET을 생성할 수 있었으며, paired I2I를 적용할 경우 보다 높은 성능을 기대할 수 있었다. 이를 통해 PET 영상 획득 과정에서 방사성의약품의 체내 분포에 소요되는 시간을 딥러닝 모델을 통해 줄여 PET 이미징 과정의 시간적 비용을 절감하는 데에 크게 기여할 수 있을 것으로 기대된다.

• Journal of Digestive Cancer Research
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• 제5권2호
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• pp.91-96
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• 2017

Background: To evaluate whether DM affects the SUVmax of metastatic lesions on ¹⁸F-FDG PET/CT and whether the SUVmax can influence the prognosis of metastatic PDAC patients. Methods: We conducted a retrospective study of 86 patients with metastatic PDAC who underwent PET/CT before treatment. The SUVmax of primary and metastatic lesions and the ratios of the SUVmax were measured. Long-term survival was evaluated using clinical parameters. Results: The mean SUVmax of primary lesion was lower in the DM group than in the non-DM group (4.74 vs. 5.96, p=0.009). The SUVmax for all metastatic lesions, except those in the lung, were lower in the DM group than in the non-DM group, and these differences were statistically significant in the lymph nodes and peritoneum. In the 35 patients with hepatic metastasis, higher ratios of the liver SUVmax significantly correlated with shorter OS (HR, 2.625; p=0.013). Conclusion: DM can influence the lower SUVmax of metastatic lesions as well as primary lesions. The SUVmax ratio of hepatic metastasis could influence on prognosis in metastatic PDAC patients.

• Korean Journal of Radiology
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• 제23권9호
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• pp.921-930
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• 2022

Objective: To identify epidermal growth factor receptor (EGFR) mutations in lung adenocarcinoma based on ¹⁸F-fluorodeoxyglucose (FDG) PET/CT radiomics and clinical features and to distinguish EGFR exon 19 deletion (19 del) and exon 21 L858R missense (21 L858R) mutations using FDG PET/CT radiomics. Materials and Methods: We retrospectively analyzed 179 patients with lung adenocarcinoma. They were randomly assigned to training (n = 125) and testing (n = 54) cohorts in a 7:3 ratio. A total of 2632 radiomics features were extracted from the tumor region of interest from the PET (1316) and CT (1316) images. Six PET/CT radiomics features that remained after the feature selection step were used to calculate the radiomics model score (rad-score). Subsequently, a combined clinical and radiomics model was constructed based on sex, smoking history, tumor diameter, and rad-score. The performance of the combined model in identifying EGFR mutations was assessed using a receiver operating characteristic (ROC) curve. Furthermore, in a subsample of 99 patients, a PET/CT radiomics model for distinguishing 19 del and 21 L858R EGFR mutational subtypes was established, and its performance was evaluated. Results: The area under the ROC curve (AUROC) and accuracy of the combined clinical and PET/CT radiomics models were 0.882 and 81.6%, respectively, in the training cohort and 0.837 and 74.1%, respectively, in the testing cohort. The AUROC and accuracy of the radiomics model for distinguishing between 19 del and 21 L858R EGFR mutational subtypes were 0.708 and 66.7%, respectively, in the training cohort and 0.652 and 56.7%, respectively, in the testing cohort. Conclusion: The combined clinical and PET/CT radiomics model could identify the EGFR mutational status in lung adenocarcinoma with moderate accuracy. However, distinguishing between EGFR 19 del and 21 L858R mutational subtypes was more challenging using PET/CT radiomics.