• Title/Summary/Keyword: CT/MRI/PET

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Clinical Application of $^{18}F-FDG$ PET in Wilms Tumor (빌름스 종양 (Wilms Tumor)에서 $^{18}F-FDG$ PET의 임상 이용)

  • Seok, Ju-Won
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.137-139
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    • 2008
  • Wilms Tumor is a great therapeutic success story within pediatric oncology. Therefore, accurate initial staging is needed to assess tumor spread and to assign patients appropriately to the different risk branches. However, it is recognized that FDG-PET can provide useful information about tumor and has better accuracy than CT and MRI for staging, but its role in Wilms tumor is unclear. According to clinical research data, FDG PET may be useful for the management of selected patients with Wilms tumors.

Pelvic insufficiency fracture after radiotherapy in patients with cervical cancer in the era of PET/CT

  • Park, Shin-Hyung;Kim, Jae-Chul;Lee, Jeong-Eun;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.29 no.4
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    • pp.269-276
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    • 2011
  • Purpose: To determine the incidence, risk factors, and clinical characteristics of pelvic insufficiency fracture (PIF) in patients with cervical cancer. Materials and Methods: Between July 2004 and August 2009, 235 patients with non-metastatic cervical cancer were treated with definitive chemoradiation or postoperative radiotherapy. Among 235 patients, 117 (49.8%) underwent the first positron emission tomography/computed tomography (PET/CT) within 1 year after radiotherapy. The median radiation dose was 55 Gy (range, 45 to 60 Gy). Medical charts and imaging studies, including PET/CT, magnetic resonance imaging (MRI), CT. bone scintigraphy were reviewed to evaluate the patients with PIF. Results: Among 235 patients, 16 developed PIF. The 5-year detection rate of PIF was 9.5%. The 5-year detection rate of PIF in patients who underwent the first PET/CT within a year was 15.6%. The median time to development of PIF was 12.5 months (range, 5 to 30 months). The sites of fracture included 12 sacroiliac joints, 3 pubic rami, 3 iliac bones, and 1 femoral neck. Eleven of 16 patients having PIF complained of hip pain requiring medications. One patient required hospitalization for pain control. The significant risk factors of PIF were old age, body mass index less than 23, bone mineral density less than -3.5 SD, and the first PET/CT within a year after radiotherapy. Radiation dose and concurrent chemotherapy had no impact on PIF rate. Conclusion: PIFs were not rare after pelvic radiotherapy in cervical cancer patients in the era of PET/CT. Timely diagnosis and management of PIF can improve quality of life in patients with cervical cancer, in addition to reducing unnecessary medical expenses.

Granuloma Resulting from the Cervical Metallic Plate, Masquerading as Posterior Pharyngeal Wall Cancer (하인두 후벽암으로 오인된 경추 내고정 금속판 삽입 후 발생한 육아종 1예)

  • Kim, Seung-Woo;Kim, Young-Bae;Sah, Dae-Jin
    • Korean Journal of Head & Neck Oncology
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    • v.27 no.2
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    • pp.218-221
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    • 2011
  • The anterior approach to the cervical spine surgery is associated with possible complications such as dysphagia, hoarseness and granuloma formation etc. Because of orthopedic metallic plates, the increasing or focal uptake pattern may be demonstrated in $^{18}F$-FDG PET/CT scan. A 67-year-old-man came to our department, complained of dysphagia during the 4 months. He underwent cervical spine surgery three years ago. The CT and MRI findings mimicked typical posterior pharyngeal wall cancer with cervical metastasis. Furthermore, the SUV in $^{18}F$-FDG PET/CT was 10.3. But he was finally diagnosed as a granuloma resulting from the metallic cervical implants. The clinical correlation and medical history should be taken into account to avoid false-positive findings in PET/CT and to avoid many erroneous diagnostic pathways.

Study of Nuclear medical imaging tests patient of Claustrophobia (폐소공포증 환자의 핵의학 영상검사에 관한 연구)

  • Kang, Yong-Gil;Hong, Jin-Woong;Yang, Han-Joon;Park, Sung-Su;Lee, Gui-Won;Kim, Keung-Sik
    • Korean Journal of Digital Imaging in Medicine
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    • v.15 no.1
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    • pp.55-59
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    • 2013
  • Patients who had claustrophobia tend to feel fear when they were scanned by an MRI, CT, PET-CT, or using a gamma camera scan. In this paper, claustrophobic patients were tested to find effective ways by changing patient's positions. For this paper, PET-CT scan in patients who had claustrophobia were used in the prone position. Prone position helped to maintain stable position and to get a h0igh quality of inspection without failure. Thus, as claustrophobic patients were requested taking prone position, they could feel comfortable. In a confined space, prone position for the claustrophobic patients who had a fear of the PET-CT examination would be expected to reduce the failure rate of inspection.

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Recent Advances in Nuclear Medicine Imaging Instrumentation (핵의학 영상기기의 최근 진보)

  • Jung, Jin-Ho;Choi, Yong;Hong, Key-Jo;Min, Byung-Jun;Hu, Wei;Kang, Ji-Hoon
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.2
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    • pp.98-111
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    • 2008
  • This review introduces advances in clinical and pre-clinical single photon emission computed tomography (SPECT) and positron emission tomography (PET) providing noninvasive functional images of biological processes. Development of new collimation techniques such as multi-pinhole and slit-slat collimators permits the improvement of system spatial resolution and sensitivity of SPECT. Application specific SPECT systems using smaller and compact solid-state detector have been customized for myocardial perfusion imaging with higher performance. Combined SPECT/CT providing improved diagnostic and functional capabilities has been introduced. Advances in PET and CT instrumentation have been incorporated in the PET/CT design that provide the metabolic information from PET superimposed on the anatomic information from CT. Improvements in the sensitivity of PET have achieved by the fully 3D acquisition with no septa and the extension of axial field-of-view. With the development of faster scintillation crystals and electronics, time-of-flight (TOF) PET is now commercially available allowing the increase in the signal-to-noise ratio by incorporation of TOF information into the PET reconstruction process. Hybrid PET/SPECT/CT systems has become commercially available for molecular imaging in small animal models. The pre-clinical systems have improved spatial resolution using depth-of-interaction measurement and new collimators. The recent works on solid state detector and dual modality nuclear medicine instrumentations incorporating MRI and optical imagers will also be discussed.

Quantitative Feasibility Evaluation of 11C-Methionine Positron Emission Tomography Images in Gamma Knife Radiosurgery : Phantom-Based Study and Clinical Application

  • Lim, Sa-Hoe;Jung, Tae-Young;Jung, Shin;Kim, In-Young;Moon, Kyung-Sub;Kwon, Seong-Young;Jang, Woo-Youl
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.476-486
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    • 2019
  • Objective : The functional information of $^{11}C$-methionine positron emission tomography (MET-PET) images can be applied for Gamma knife radiosurgery (GKR) and its image quality may affect defining the tumor. This study conducted the phantom-based evaluation for geometric accuracy and functional characteristic of diagnostic MET-PET image co-registered with stereotactic image in Leksell $GammaPlan^{(R)}$ (LGP) and also investigated clinical application of these images in metastatic brain tumors. Methods : Two types of cylindrical acrylic phantoms fabricated in-house were used for this study : the phantom with an array-shaped axial rod insert and the phantom with different sized tube indicators. The phantoms were mounted on the stereotactic frame and scanned using computed tomography (CT), magnetic resonance imaging (MRI), and PET system. Three-dimensional coordinate values on co-registered MET-PET images were compared with those on stereotactic CT image in LGP. MET uptake values of different sized indicators inside phantom were evaluated. We also evaluated the CT and MRI co-registered stereotactic MET-PET images with MR-enhancing volume and PET-metabolic tumor volume (MTV) in 14 metastatic brain tumors. Results : Imaging distortion of MET-PET was maintained stable at less than approximately 3% on mean value. There was no statistical difference in the geometric accuracy according to co-registered reference stereotactic images. In functional characteristic study for MET-PET image, the indicator on the lateral side of the phantom exhibited higher uptake than that on the medial side. This effect decreased as the size of the object increased. In 14 metastatic tumors, the median matching percentage between MR-enhancing volume and PET-MTV was 36.8% on PET/MR fusion images and 39.9% on PET/CT fusion images. Conclusion : The geometric accuracy of the diagnostic MET-PET co-registered with stereotactic MR in LGP is acceptable on phantom-based study. However, the MET-PET images could the limitations in providing exact stereotactic information in clinical study.

Primary Pelvic Peritoneal Yolk Sac Tumor in the Post-Pubertal Female: a Case Report with Literature Review

  • Kim, Myojeong;Lee, Eun Ji;Hwang, Jiyoung;Hong, Seong Sook;Chang, Yun-Woo;Oh, Eunsun;Nam, Bo Da;Choi, Inho;Kim, Jeong Sig
    • Investigative Magnetic Resonance Imaging
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    • v.23 no.4
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    • pp.367-373
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    • 2019
  • Yolk sac tumors are rare malignant germ cell neoplasms that usually arise from the gonads. Extragonadal yolk sac tumors (EGYSTs) frequently occur in the mediastinum in post-pubertal females. EGYSTs in the pelvis are extremely rare, and to date, only thirteen cases have been reported in the English literature. Among them, the primary EGYST of the pelvic peritoneum in post-pubertal females has only been reported in ten cases. The present case describes a 26-year-old female diagnosed with primary peritoneal yolk sac tumor located in the rectouterine pouch. We report clinical and tumor imaging features, including ultrasound, computed tomography (CT), magnetic resonance images (MRI), positron emission tomography-computed tomography (PET-CT), and present a review of the literature.

Imaging Assessment of Primary Prostate Cancer, Focused on Advanced MR Imaging and PET/CT (자기공명영상과 PET/CT를 중심으로 한 전립선 암의 영상 진단)

  • Jang, Jin-Hee;Byun, Jae-Young;Kim, Min-Sung;Lee, Young-Joon;Oh, Sun-Nam;Rha, Sung-Eun;Yoo, Ie-Ryung
    • Investigative Magnetic Resonance Imaging
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    • v.12 no.2
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    • pp.89-99
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    • 2008
  • Imaging assessment of prostate cancer is one of the most difficult sections of oncology imaging. Detecting, localizing and staging of the primary prostate cancer by preoperative imaging are still challenging for the radiologist. Magnetic resonance (MR) imaging provides excellent soft tissue contrast and is widely used for solid organ imaging, but results of preoperative imaging of the prostate gland with conventional MR imaging is unsatisfactory. Positron emission tomography and computed tomography (PET/CT) is the cornerstone in oncology imaging, but some limitations prohibit the assessment of primary prostate cancer with PET or PET/CT. Recent studies to overcome these insufficient accuracies of imaging evaluation of primary prostate cancers with advanced MR techniques and PET and PET/CT are reported. In this article, we review the imaging findings of prostate cancer on variable modalities, focused on MR imaging and PET/CT.

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The Imaging Features of Desmoid Tumors: the Usefulness of Diffusion Weighted Imaging to Differentiate between Desmoid and Malignant Soft Tissue Tumors

  • Lee, Seung Baek;Oh, Soon Nam;Choi, Moon Hyung;Rha, Sung Eun;Jung, Seung Eun;Byun, Jae Young
    • Investigative Magnetic Resonance Imaging
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    • v.21 no.3
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    • pp.162-170
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    • 2017
  • Purpose: To evaluate the imaging findings of desmoid tumors using various imaging modalities and to evaluate whether diffusion-weighted imaging (DWI) can help differentiate between desmoid and malignant tumors. Materials and Methods: The study included 27 patients with pathologically confirmed desmoid tumors. Two radiologists reviewed 23 computed tomography (CT), 12 magnetic resonance imaging (MRI) and 8 positron emission tomography-computed tomography (PET-CT) scans of desmoid tumors and recorded data regarding the shape, multiplicity, size, location, degree of enhancement, and presence or absence of calcification or hemorrhage. The signal intensity of masses on T1- and T2-weighted imaging and the presence or absence of whirling or band-like low signal intensity on T2-weighted imaging were recorded. The apparent diffusion coefficient (ADC) values of the desmoid tumors in nine patients with DWIs were compared with the ADC values of 32 malignant tumors. The maximum standardized uptake value ($SUV_{max}$) on PET-CT images was measured in 8 patients who underwent a PET-CT. Results: The mean size of the 27 tumors was 6.77 cm (range, 2.5-26 cm) and four tumors exhibited multiplicity. The desmoid tumors were classified by shape as either mass forming (n = 18), infiltrative (n = 4), or combined (n = 5). The location of the tumors was either intra-abdominal (n = 15), within the abdominal wall (n = 8) or extra-abdominal (n = 4). Among the 27 tumors, 21 showed moderate to marked enhancement and 22 showed homogeneous enhancement. Two tumors showed calcifications and one displayed hemorrhage. Eleven of the 12 MR T2-weighted images showed whirling or band-like low signal intensity areas in the mass. The mean ADC value of the desmoid tumors ($1493{\times}10^{-6}mm^2/s$) was significantly higher than the mean of the malignant soft tissue tumors ($873{\times}10^{-6}mm^2/s$, P < 0.001). On the PET-CT images, all tumors exhibited an intermediate $SUV_{max}$ (mean, 3.7; range, 2.3-4.5). Conclusion: Desmoids tumors showed homogenous, moderate to marked enhancement on CT and MRI scans and a characteristic whirling or band-like pattern on T2-weighted images. DWI can be useful for the differentiation of desmoid tumors from malignant soft tissue tumors.