• Radiation Oncology Journal
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• v.33 no.2
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• pp.126-133
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• 2015

Purpose: To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. Materials and Methods: We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. Results: The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. Conclusion: Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic significance in early uterine cervical cancer patients. More effective systemic treatments might be needed to reduce distant metastasis in these patients.

• Radiation Oncology Journal
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• v.33 no.1
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• pp.50-56
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• 2015

Purpose: To investigate the coverage of axillary lymph node with tangential breast irradiation fields by using virtual lymph node (LN) analysis. Materials and Methods: Forty-eight women who were treated with whole breast irradiation after breast-conserving surgery were analyzed. The axillary and breast volumes were delineated according to the Radiation Therapy Oncology Group (RTOG) contouring atlas. To generate virtual LN contours, preoperative fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans with identifiable LN were fused with the CT scans, and the virtual LN contour were delineated on the CT. Results: The median level I and II axillary volume coverage percentages at the $V_{D95%}$ line were 33.5% (range, 5.3% to 90.4%) and 0.6% (range, 0.0% to 14.6%), respectively. Thirty-one LNs in 18 patients were delineated (26 in level I and 5 in level II). In the level I axilla, 84.6% of virtual LNs were encompassed by the 95% isodose line. In the level II axilla, by contrast, none of the virtual LNs were encompassed by the 95% isodose volumes. There was a substantial discrepancy between the RTOG contouring atlas-based axillary volume analysis and the virtual LN analysis, especially for the level I axillary coverage. The axillary volume coverage was associated with the body mass index (BMI) and breast volume. Conclusion: The tangential breast irradiation did not deliver adequate therapeutic doses to the axillary region, particularly those in the level II axilla. Patients with small breast volumes or lower BMI showed reduced axillary coverage from the tangential breast fields. For axillary LN irradiation, individualized anatomy-based radiation fields for patients would be necessary.

• 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.

• Tuberculosis and Respiratory Diseases
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• v.68 no.5
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• pp.290-293
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• 2010

A hidden primary tumor presenting as an isolated lung mass is a diagnostic challenge to physicians because the diagnosis of lung cancer is likely to be made if the histologic findings are not inconsistent with lung cancer. A large lung mass was found incidentally in a 59-year-old man. Although adenocarcinoma was diagnosed by percutaneous needle biopsy, thyroid transcription factor-1 (TTF-1) immunostaining was negative, raising suspicion that there was another primary site. There was no abnormal finding except for the lung mass on a $^{18}FDG$-PET/CT scan and the patient did not complain of any discomfort. Finally, prostatic cancer was confirmed through the study of tumor markers and prostate-specific antigen (PSA) immunostaining. Because of the rare presentation of a single lung mass in malignancies that have another primary site, physicians should carefully review all data before making a final diagnosis of lung cancer.

• Investigative Magnetic Resonance Imaging
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• v.13 no.1
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• pp.101-105
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• 2009

We report radiological findings of ultrasonography (US), 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) computed tomography (CT), and magnetic resonance (MR) imaging for a rare case of skeletal muscle metastasis from an underlying known malignant phyllodes tumor. To our knowledge, there has been no previous published report of imaging findings of skeletal muscle metastasis from a sarcoma such as malignant phyllodes tumor.

• The Korean Journal of Nuclear Medicine
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• v.39 no.4
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• pp.252-256
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• 2005

Purpose: Thyroglobulin (Tg) is a valuable and sensitive tool as a marker for diagnosis and follow-up for several thyroid disorders, especially, in the follow-up of patients with differentiated thyroid cancer (DTC). Often, clinical decisions rely entirely on the serum Tg concentration. But the Tg assay is one of the most challenging laboratory measurements to perform accurately owing to antithyroglobulin antibody (Anti-Tg). In this study, we have compared the degree of Anti-Tg effects on the measurement of Tg between availale Tg measuring kits. Materials and Methods: Measurement of Tg levels for standard Tg solution was performed with two different kits commercially available (A/B kits) using immunoradiometric assay technique either with absence or presence of three different concentrations of Anti-Tg. Measurement of Tg for patient's serum was also performed with the same kits. Patient's serum samples were prepared with mixtures of a serum containing high Tg levels and a serum containg high Anti-Tg concentrations. Results: In the measurements of standard Tg solution, presence of Anti-Tg resulted in falsely lower Tg level by both A and B kits. Degree of Tg underestimation by h kit was more prominent than B kit. The degree of underestimation by B kit was trivial therefore clinically insignificant, but statistically significant. Addition of Anti-Tg to patient serum resulted in falsely lower Tg levels with only A kit. Conclusion: Tg level could be underestimated in the presence of anti-Tg. Anti-Tg effect on Tg measurement was variable according to assay kit used. Therefore, accuracy test must be performed for individual Tg-assay kit.

• The Korean Journal of Nuclear Medicine Technology
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• v.16 no.1
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• pp.38-43
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• 2012

Purpose: Patients injected with FDG use the bathroom that Measured surface contamination level and spatial dose rate. This study about the effect that result affects workers in same part. Materials and Methods: Group1 is St. Vincent' s hospital's 60case. Group 2 is Bucheon St. Mary's hospital's 50case. Last case is lower the average daily number of patients than group 2. Measured time is 8:00, 10:00, 13:00, 15:00 and 17:00. Measured part is 4 point of toilet, basin and wastepaper basket, also measured accumulation dose of toilet during 3 month. Hospitals is installed PET/CT ware surveyed on presence of bathroom that used only by patient and worker has been using the bathroom. Results: The highest average surface contamination level of toilet is group1($8.38{\pm}4.56$), but the highest spatial dose rate is group3. Cumulative exposure dose measured by TLD during 3months is St.Vincent's hospital 0.78 mSv and Bucheon St.Mary's hospital 0.37 mSv. And result of survey is 16.12% worker using the bathroom. Conclusions: The more daily number of patient, the higher surface contamination level of bathroom. Especially, wastepaper basket's surface contamination level is exceed the reference value $4Bq/cm^2$. Based on This survey, Bathroom require special attention and proper decontamination.

• Journal of radiological science and technology
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• v.39 no.3
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• pp.377-384
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• 2016

This is a study on the optimized dispensing of the auto dispenser used for the purpose of reducing the exposure dose and accurate radiation dose of radioisotope with regard to the PET/CT practitioners. The research method was to find the optimized dispensing method through evaluating the results according to the syringe type, dispensing rate, and vial pressure and through the application of corrected values. As a result of this study, 9.38 mCi has been dispensed on average in the case of 5 ml syringe, and the reproducibility close to 10 mCi was shown at the dispense of 9.55 mCi in the case of 3 ml syringe. In the evaluation according to the dispensing rate, the quantity of radioisotope close to 10 mCi was dispensed at the rate of 5 mm/min when the measurement was carried out by increasing the rate by 5 mm/min units in the order of 5, 10, 15 and 20 mm/min. In the evaluation result according to the vial pressure before/after the use of Needle filter, it was measured to be 9.53 mCi before use and 9.84 mCi after use confirming that the dispensing after using Needle filter showed the optimal value. In addition, in the evaluation of radioactivity before/after the application of corrected values according to the increase in dispense frequency, it was measured 9.53 mCi before correction and 10.07 mCi after correction confirming that the value with correction applied was closer to the quantitative value. Thus, a good optimized method was confirmed to use a 3 ml syringe with dispensing rate of 5 mm/min, to use a Needle filter at dispensing, and to set the corrected value of [$y=0.097{\times}x$] according to the dispensing frequency of equipment.

• Journal of Yeungnam Medical Science
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• v.25 no.2
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• pp.128-133
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• 2008

Acinar cell carcinoma is a rare tumor that represents 1~2% of all pancreatic cancers. Clinical and radiologic findings are inconclusive in this disease. Acinar cell carcinoma is characterized by rapid progression and early metastasis, which lead to its poor prognosis. A 41-year-old man was admitted to our hospital for abdominal pain. Abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed a splenic mass, which was being invaded by a pancreatic tail mass and which had increased $^{18}F$-fluorodeoxyglucose (FDG) uptake. Primary radical distal pancreatectomy and splenectomy were performed. Pathologic findings revealed an acinar cell carcinoma of the pancreas. The patient underwent a total gastrectomy three months later because of gastric recurrence. Four months later, multiple hepatic metastases were discovered, and the patient underwent a left hepatectomy. During treatment with capecitabine, there was no evidence of tumor progression for 14 months. We report a case of metastatic pancreatic acinar cell carcinoma, which did not progress for an extended period while the patient was being treated with capecitabine.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.3 no.1
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• pp.18-24
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• 2017

Patient-specific image-based internal dosimetry involves using the patient's individual anatomy and spatial distribution of radioactivity over time to obtain an absorbed dose calculation. Individual absorbed dose was calculated by accumulated activity multiply S-value of each organs. The aim of this study was to calculate the S-values using Monte Carlo simulation in monkey and mouse and evaluation of absorbed dose in each organ. Self-irradiation S-value of monkey heart self-irradiation was 3.15E-03 mGy-g/MBq-s, lung self-irradiation was 8.94E-04 mGy-g/MBq-s and liver self-irradiation S-value was 2.23E-03 mGy-g/MBq-s. Mouse heart self-irradiation S-value was 1.95E-01 mGy-g/MBq-s, lung was 9.59E-02 mGy-g/MBq-s, and liver was 1.40E-03 mGy-g/MBq-s. The results of this study show that the calculation protocol of image based individual absorbed dose of each organ using Monte Carlo simulation. Therefore, this study may be applied to calculate human specific absorbed dose.