• Journal of radiological science and technology
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• v.39 no.3
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• pp.369-376
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• 2016

Positron Emission Tomography(PET) is nuclear medical tests which is a combination of several compounds with a radioactive isotope that can be injected into body to quantitatively measure the metabolic rate (in the body). Especially, Phenomena that increase (sing) glucose metabolism in cancer tissue using the $^{18}F$-FDG (Fluorodeoxyglucose) is utilized widely in cancer diagnosis. And then, Numerous studies have been reported that incidence seems high availability even in the modern diagnosis of dementia and Parkinson's (disease) in brain disease. When using a dynamic PET iamge including the time information in the static information that is provided for the diagnosis many can increase the accuracy of diagnosis. For this reason, clinical researchers getting great attention but, it is the lack of tools to conduct research. And, it interfered complex mathematical algorithm and programming skills for activation of research. In this study, in order to easy to use and enable research dPET, we developed the software based graphic user interface(GUI). In the future, by many clinical researcher using DIA-Tool is expected to be of great help to dPET research.

• Korean Journal of Radiology
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• v.23 no.1
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• pp.112-123
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• 2022

Objective: To investigate the relationship between ¹⁸F-FDG PET/CT semi-quantitative parameters and the International Association for the Study of Lung Cancer, American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) histopathologic classification, including histological subtypes, proliferation activity, and somatic mutations. Materials and Methods: This retrospective study included 419 patients (150 males, 269 females; median age, 59.0 years; age range, 23.0-84.0 years) who had undergone surgical removal of stage IA-IIIA lung adenocarcinoma and had preoperative PET/CT data of lung tumors. The maximum standardized uptake values (SUVmax), background-subtracted volume (BSV), and background-subtracted lesion activity (BSL) derived from PET/CT were measured. The IASLC/ATS/ERS subtypes, Ki67 score, and epidermal growth factor/anaplastic lymphoma kinase (EGFR/ALK) mutation status were evaluated. The PET/CT semi-quantitative parameters were compared between the tumor subtypes using the Mann-Whitney U test or the Kruskal-Wallis test. The optimum cutoff values of the PET/CT semi-quantitative parameters for distinguishing the IASLC/ATS/ERS subtypes were calculated using receiver operating characteristic curve analysis. The correlation between the PET/CT semi-quantitative parameters and pathological parameters was analyzed using Spearman's correlation. Statistical significance was set at p < 0.05. Results: SUVmax, BSV, and BSL values were significantly higher in invasive adenocarcinoma (IA) than in minimally IA (MIA), and the values were higher in MIA than in adenocarcinoma in situ (AIS) (all p < 0.05). Remarkably, an SUVmax of 0.90 and a BSL of 3.62 were shown to be the optimal cutoff values for differentiating MIA from AIS, manifesting as pure ground-glass nodules with 100% sensitivity and specificity. Metabolic-volumetric parameters (BSV and BSL) were better potential independent factors than metabolic parameters (SUVmax) in differentiating growth patterns. SUVmax and BSL, rather than BSV, were strongly or moderately correlated with Ki67 in most subtypes, except for the micropapillary and solid predominant groups. PET/CT parameters were not correlated with EGFR/ALK mutation status. Conclusion: As noninvasive surrogates, preoperative PET/CT semi-quantitative parameters could imply IASLC/ATS/ERS subtypes and Ki67 index and thus may contribute to improved management of precise surgery and postoperative adjuvant therapy.

• The Korean Journal of Nuclear Medicine
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• v.35 no.3
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• pp.117-124
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• 2001

Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine frapping mechanism. In such cases, various nuclear imaging methods including Tl-201 Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose I-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose I-131 therapy. with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose I-131 therapy. Before I-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance I-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose I-131 therapy.

• Radiation Oncology Journal
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• v.31 no.3
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• pp.111-117
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• 2013

Purpose: To determine whether the maximum standardized uptake value (SUV) of [$^{18}F$] fluorodeoxyglucose uptake by positron emission tomography (FDG PET) ratio of lymph node to primary tumor (mSUVR) could be a prognostic factor for node positive non-small cell lung cancer (NSCLC) patients treated with definitive radiotherapy (RT). Materials and Methods: A total of 68 NSCLC T1-4, N1-3, M0 patients underwent FDG PET before RT. Optimal cutoff values of mSUVR were chosen based on overall survival (OS). Independent prognosticators were identified by Cox regression analysis. Results: The most significant cutoff value for mSUVR was 0.9 with respect to OS. Two-year OS was 17% for patients with mSUVR > 0.9 and 49% for those with mSUVR ${\leq}0.9$ (p = 0.01). In a multivariate analysis, including age, performance status, stage, use of chemotherapy, and mSUVR, only performance status (p = 0.05) and mSUVR > 0.9 (p = 0.05) were significant predictors of OS. Two-year OS for patients with both good performance (Eastern Cooperative Oncology Group [ECOG] ${\leq}1$) and mSUVR ${\leq}0.9$ was significantly better than that for patients with either poor performance (ECOG > 1) or mSUVR > 0.9, 23% (71% vs. 23%, p = 0.04). Conclusion: Our results suggested that the mSUVR was a strong prognostic factor among patients with lymph node positive NSCLC following RT. Addition of mSUVR to performance status identifies a subgroup at highest risk for death after RT.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.119-122
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• 2007

Purpose: Although liposarcoma is the second most common soft tissue sarcoma in adults, the incidence of liposarcoma of the head and neck is rare. There is only one reported case in Korea and moreover, only in adolescence. We report a case of liposarcoma on the neck in a 32-year-old male in adult. Methods: The patient had a slow growing, none tender mass on the posterior neck without lymphadenopathy, which has been present for 3 years and recurred twice during that time. MRI showed a 1.5 cm sized ovoid, well demarcated mass that was located in the subcutaneous layer of the posterior neck. Results: The mass was surgically removed. The resection margin was free of tumor on frozen biopsy and histopathologic examination indicated myxoid and round cell liposarcoma. The whole body F-18 FDG PET-CT applied on the fourteenth day postoperatively, revealed a moderate FDG-uptaking soft tissue lesion showing postoperative wound healing process on the posterior neck region and there was no distant metastasis. Conclusion: Liposarcoma is the second most common soft tissue sarcoma in adults. But, it rarely involves the head and neck region. Prognosis is principally dependent on histologic subtype and grade. Low grade liposarcoma such as well differentiated and myxoid liposarcoma tend to recur locally, rarely metastasize. On the other hand, high grade liposarcoma such as round cell and pleomorphic liposarcoma have higher rates of local recurrence and distant metastasis. Complete surgical excision provides the most effective means of treatment. Radiotherapy or chemotherapy can be used as an asjunctive treatment modality.

• Nuclear Medicine and Molecular Imaging
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• v.40 no.1
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• pp.40-47
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• 2006

Purpose: The aim of this study was to examine the effects of attenuation correction (AC) and scatter correction (SC) on the quantification of PET count rates. Materials and Methods: To assess the effects of AC and SC $^{18}F$-FDG PET images of phantom and cat brain were acquired using microPET R4 scanner. Thirty-minute transmission images using $^{68}Ge$ source and emission images after injection of FDG were acquired. PET images were reconstructed using 2D OSEM. AC and SC were applied. Regional count rates were measured using ROIs drawn on cerebral cortex including frontal, parietal, and latral temporal lobes and deep gray matter including head of caudate nucleus, putamen and thalamus for pre- and post-AC and SC images. The count rates were then normalized with the injected dose per body weight. To assess the effects of AC, count ratio of "deep gray matter/cerebral cortex" was calculated. To assess the effects of SC, ROIs were also drawn on the gray matter (GM) and white matter (WM), and contrast between them ((GM-WM)/GM was measured. Results: After the AC, count ratio of "deep gray matter/cerebral cortex" was increased by $17{\pm}7%$. After the SC, contrast was also increased by $12{\pm}3%$. Conclusion: Relative count of deep gray matter and contrast between gray and white matters were increased after AC and SC, suggesting that the AC would be critical for the quantitative analysis of cat brain PET data.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.12-16
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• 2012

Purpose : In conventional PET image reconstruction, iterative reconstruction methods such as OSEM (Ordered Subsets Expectation Maximization) have now generally replaced traditional analytic methods such as filtered back-projection. This includes improvements in components of the system model geometry, fully 3D scatter and low noise randoms estimates. SharpIR algorithm is to improve PET image contrast to noise by incorporating information about the PET detector response into the 3D iterative reconstruction algorithm. The aim of this study is evaluation of SharpIR reconstruction method in PET/CT. Materials and Methods: For the measurement of detector response for the spatial resolution, a capillary tube was filled with FDG and scanned at varying distances from the iso-center (5, 10, 15, 20 cm). To measure image quality for contrast recovery, the NEMA IEC body phantom (Data Spectrum Corporation, Hillsborough, NC) with diameters of 1, 13, 17 and 22 for simulating hot and 28 and 37 mm for simulating cold lesions. A solution of 5.4 kBq/mL of $^{18}F$-FDG in water was used as a radioactive background obtaining a lesion of background ratio of 4.0. Images were reconstructed with VUE point HD and VUE point HD using SharpIR reconstruction algorithm. For the clinical evaluation, a whole body FDG scan acquired and to demonstrate contrast recovery, ROIs were drawn on a metabolic hot spot and also on a uniform region of the liver. Images were reconstructed with function of varying iteration number (1~10). Results: The result of increases axial distance from iso-center, full width at half maximum (FWHM) is also increasing in VUE point HD reconstruction image. Even showed an increasing distances constant FWHM. VUE point HD with SharpIR than VUE point HD showed improves contrast recovery in phantom and clinical study. Conclusion: By incorporating more information about the detector system response, the SharpIR algorithm improves the accuracy of underlying model used in VUE point HD. SharpIR algorithm improve spatial resolution for a line source in air, and improves contrast recovery at equivalent noise levels in phantoms and clinical studies. Therefore, SharpIR algorithm can be applied as through a longitudinal study will be useful in clinical.

• The Korean Journal of Nuclear Medicine
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• v.38 no.2
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• pp.180-189
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• 2004

Although the outcome of cancer patients after cytotoxic chemotherapy is related diverse mechanisms, multidrug resistance (MDR) for chemotherapeutic drugs due to cellular P-glycoprotein (Pgp) or multidrug-resistance associated protein (MRP) is most important factor in the chemotherapy failure to cancer. A large number of pharmacologic compounds, including verapamil, quinidine, tamoxifen, cyclosporin A and quinolone derivatives have been reported to overcome MDR. Single photon emission computed tomography (SPECT) and positron emission tomography (PET) are available for the detection of Pgp and MRP-mediated transporter. $^{99m}Tc$-MIBI and other $^{99m}Tc$-radiopharmaceuticals are substrates for Pgp and MRP, and have been used in clinical studies for tumor imaging, and to visualize blockade of PgP-mediated transport after modulation of Pgp pump. Colchicine, verapamil and daunorubicin labeled with $^{11}C$ have been evaluated for the quantification of Pgp-mediated transport with PET in vivo and reported to be feasible substrates with which to image Pgp function in tumors. Leukotrienes are specific substrates for MRP and $N-[^{11}C]acetyl-leukotriene$ E4 provides an opportunity to study MRP function non-invasively in vivo. SPECT and PET pharmaceuticals have successfully used to evaluate pharmacologic effects of MDR modulators. Imaging of MDR and reversal of MDR with bioluminescence in a living animal is also evaluated for future clinical trial. We have described recent advances in molecular imaging of MDR and reviewed recent publications regarding feasibility of SPECT and PET imaging to study the functionality of MDR transporters in vivo.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.15
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• pp.6279-6284
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• 2015

Opisthorchis viverrini (OV)-induced cholangiocarcinoma (CCA) is an important cancer in the Great Mekong region, particularly in Thailand. Limitations of treatment options and the lack of an effective diagnostic tool for early detection of CCA are major concerns for the control of this type of cancer. The aim of the study was to investigate anti-CCA activity of the ethanolic extract of Atractylodes lancea (Thunb.) DC., and the applicability of positron emission tomography-computed tomography (PET-CT) as a tool for detection and monitoring the progression of CCA in Opisthorchis viverrini (OV)/dimethylnitrosamine (DMN)-induced CCA hamsters. Male Syrian hamsters were used for toxicity tests and anti-CCA activity evaluation. Development of CCA was induced by initial feeding of 50 metacercariae of OV, followed by drinking water containing 12.5 ppm of DMN in hamsters. The ethanolic extract of A. lancea (Thunb.) DC. was administered orally for 30 days. PET-CT was performed every 4 weeks after initiation of CCA using 18F-fluorodeoxyglucose ($^{18}F-FDG$). Results from the present study suggest that the ethanolic extract of A. lancea (Thunb.) DC. rhizome exhibited promising anti-CCA activity and safety profile in the OV/DMN-induced hamster model. To successfully apply PET-CT as a tool for early detection of tumor development and progression, modification of radiolabeling approach is required to improve its specificity for CCA cells.

• The Korean Journal of Nuclear Medicine
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• v.39 no.1
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• pp.1-8
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• 2005

This paper is described on the development of KOTRON-13 and recent status of PET cyclotron by commercial cyclotron companies. KIRAMS has developed medical cyclotron which is KIRAMS-13. Samyoung Unitech produces KOTRON-13 with transfered technology by KIRAMS. As a part of Regional Cyclotron Installation Protect, KOTRON-13 cyclotrons and $[18F]FDG$ production modules are being installed at regional cyclotron centers in Korea. The medical concern with radiation technology has been growing for the last several years. Early cancer diagnosis through the cyclotron and PET-CT have been brought to public attention by commercial cyclotron models in the world. The new commercial cyclotron models are introduced compact low energy cyclotrons developed by CTI, GE, Sumitomo in recent. It produces different short-lived radioisotopes, such as $[^{18}F],\;[^{11}C],\;[^{13}N]\;and\;[^{15}O]$. For the better reliability acceleration particle is proton only. The characteristics of new model cyclotrons are changed to lower energy corresponding to less 13 MeV. New models have self-shielding and low power consumption. Design criteria for the different types of commercial cyclotrons are described with reference to hospital demands.