• IEMEK Journal of Embedded Systems and Applications
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• v.18 no.6
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• pp.267-275
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• 2023

This paper presents the development of specialized software for annotating volume-of-interest on ¹⁸F-FDG PET/CT images with the goal of facilitating the studies and diagnosis of head and neck cancer (HNC). To achieve an efficient annotation process, we employed the SE-Norm-Residual Layer-based U-Net model. This model exhibited outstanding proficiency to segment cancerous regions within ¹⁸F-FDG PET/CT scans of HNC cases. Manual annotation function was also integrated, allowing researchers and clinicians to validate and refine annotations based on dataset characteristics. Workspace has a display with fusion of both PET and CT images, providing enhance user convenience through simultaneous visualization. The performance of deeplearning model was validated using a Hecktor 2021 dataset, and subsequently developed semi-automatic annotation functionalities. We began by performing image preprocessing including resampling, normalization, and co-registration, followed by an evaluation of the deep learning model performance. This model was integrated into the software, serving as an initial automatic segmentation step. Users can manually refine pre-segmented regions to correct false positives and false negatives. Annotation images are subsequently saved along with their corresponding ¹⁸F-FDG PET/CT fusion images, enabling their application across various domains. In this study, we developed a semi-automatic annotation software designed for efficiently generating annotated lesion images, with applications in HNC research and diagnosis. The findings indicated that this software surpasses conventional tools, particularly in the context of HNC-specific annotation with ¹⁸F-FDG PET/CT data. Consequently, developed software offers a robust solution for producing annotated datasets, driving advances in the studies and diagnosis of HNC.

• The Korean Journal of Nuclear Medicine
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• v.33 no.5
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• pp.439-451
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• 1999

Purpose : It is important to differentiate malignant from benign lesions of intraocular masses in choosing therapeutic plan. Biopsy of intraocular tumor is not recommended due to the risk of visual damage. We evaluated the usefulness of F-18-FDG PET imaging in diagnosing intraocular neoplasms. Materials and Methods: F-18-FDG PET scan was performed in 13 patients (15 lesions) suspected to have malignant intraocular tumors. There were 3 benign lesions (retinal detachment, choroidal effusion and hemorrhage) and 10 patients with 12 malignant lesions (3 melanomas, 7 retinoblastomas and 2 metastatic cancers). Regional eye images ($256{\times}256$ and $128{\times}128$ matrices) were obtained with or without attenuation correction. Whole body scan was also performed in eight patients (3 benign and 6 malignant lesions). Results: All malignant lesions were visualized while all benign lesions were not visualized. The mean peak standardized uptake value (SUV) of malignant lesions was $2.64{\pm}0.57g/ml$. There was no correlations between peak SUV and tumor volume. Two large malignant lesions ($> 1000 mm^3$) showed hot uptake on whole body scan. But two medium-sized lesions ($100-1000mm^3$) looked faint and two small ($<100mm^3$) lesions were not visualized. The images reconstructed with $256{\times}256$ matrix showed lesions more clearly than those with $128{\times}128$ matrix Conclusion: F-18-FDG PET scan is highly sensitivity in detecting malignant intraocular tumor For the evaluation of small-sized intraocular lesions, whole body scan is not appropriate because of low sensitivity. A regional scan with sufficient acquisition time is recommended for that purpose. Image reconstruction in matrix size of $256{\times}256$ produced clearer images than the ones in $128{\times}128$, but it does not affect the diagnostic sensitivity.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.39-45
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• 2008

PET or PET/CT detects only less than 50% of early gastric cancer and 62-98% of advanced gastric cancer. Therefore, mass screening programs are recommended for all adults over the age of 40 for early detection and early treatment of gastric cancer through endoscopy or various radiological tests. The most important step after diagnosis of gastric cancer is accurate staging, which mainly evaluates tumor resectability to avoid unnecessary surgery. Important factors that affect tumor resectability are whether the tumor can be separated from adjacent organs or important blood vessels, the extent of lymph node metastasis, presence of peritoneal metastasis, or distant organ metastasis. To evaluate the extent of local tumor invasion, anatomical imaging that has superior spatial resolution is essential. There are a few studies on prognostic significance of FDG uptake with inconsistent results between them. In spite of lower sensitivity for lymph node staging, the specificity of CT and PET are very high, and the specificity for PET tends to be higher than that for CT. Limited data published so far show that PET seems less useful in the detection of lung and bone metastasis. In the evaluation of pleural or peritoneal metastasis, PET seems very specific but insensitive as well. When FOG uptake of primary tumor is low, distant metastasis also tends to show low FDG uptake reducing its detection on PET. There are only a few data available in the evaluation of recurrence detection and treatment response using FDG PET or PET/CT.

• Journal of the Korean Society of Radiology
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• v.16 no.2
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• pp.95-102
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• 2022

This study compares the difference between the remaining amount in syringes according to injection method and the dose of physiological saline when the radiopharmaceutical ¹⁸F-FDG isotope is injected into patients who visited the hospital for PET examination. After performing a CT or MRI using a contrast medium when ¹⁸F-FDG was injected into 40 patients who came to the hospital for PET examination without removing the 3-way, the radioactivity remaining in the syringe and the 3-way was measured and the dose of radioactivity confirmed. At this time, 20 patients were divided into different dose groups of physiological saline. Another injection method was used to compare the remaining amount of the syringe and the difference in the remaining amount according to the amount of physiological saline when the injection was performed with an extension. After an injection of ¹⁸F-FDG, the actual administered dose was confirmed by measuring the radioactivity remaining in the syringe and the 3-way or extension with a calibrator. As a result of measuring the radioactivity of the syringe before administering the radiopharmaceutical and the radioactivity of the syringe and the 3-way or extension after administration, the 3-way injection method in 10 cc's of physiological saline had the lowest residual amount. The remaining amount increased in the order of the extension to 10 cc's of saline and the 3-way to 5 cc's of saline. Likewise, the 5 cc's saline solution and the extension injection method demonstrated the highest residual amounts. The residual difference with the lowest level of remaining injection method was found to be 0.053 mCi. It was found that in a PET examination, by considering the radioactivity remaining in the 3-way and extension and by adjusting the dose of physiological saline, if the intended dose to be administered to the actual patient is determined, it is possible to administer the radiopharmaceutical to the patient more accurately.

• Progress in Medical Physics
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• v.14 no.2
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• pp.108-123
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• 2003

The purpose of this study is to evaluate the contribution of $^{18}$ F-FDG brain PET in the differentiating Idiopathic parkinson's diesease (IPD), progressive supranuclear palsy (PSP), and multiple system atrophy (MSA). We studied 24 patients with parkinsonism : 8 patients (mean age 67.9$\pm$10.7 y: M/F : 3/5) with IPD, 9 patients (57.9$\pm$9.2 y : M/F : 4/5) with MSA and 7 patients (67.6$\pm$4.8 y : M/F 3/4) with PSP. All patients with parkinsonism and 22 age-matched normal controls underwent $^{18}$ F FDG PET in 3D mode after the injection of 370 MBq $^{118}$ F FDG. The patients with IPD, MSh and PSP were compared with a normal control group by a two-sided t-test of SPM99 (uncorrected P<0.001, extent threshold>100 voxel). All three parkinsonism groups, showed significant hypometabolism in the cerebral neocortex compared to the normal control group. However, the three groups displayed different metabolism in the subcortical structure, brain stem, and cerebellum. In IPD, there was no significant hypometabolism in the putamen, brain stem and cerebellum. However, MSA patients showed significant hypometabolism in the striatum, pons, and cerebellum compared to the normal controls and IPD patients. In addition, PSP showed significant hypometabolism in the caudate nuclei, the thalamus, midbrain, and the cingulate gyrus compared to the normal controls, the IPD, and MSA groups (IPD vs Normal sensitivity/specificity : 75%/l00%, MSA vs Normal sensitivity/specificity :100%/87%, PSP vs Normal sensitivity/specificity : 86%/94%). Our results show that the regional metabolism of IPD, MSA, and PSP is different mainly in the striatum, thalamus, brain stem and cerebellum. An assessment of the $^{18}$ F-FDG PET scan images using SPM may be a useful adjunct to a clinical examination in making a differential diagnosis of Parkinsonism.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.1
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• pp.49-53
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• 2007

Purpose: It was reported that CT-based measured attenuation correction (CT-MAC) produced radioactivity concentration values significantly higher than $^{68}Ge$-based segmented attenuation correction (Ge-SAC) in PET images. However, it was unknown whether the radioactivity concentration difference resulted from different sources (CT vs. Ge) or types (MAC vs. SAC) of attenuation correction (AC). We evaluated the influences of the source and type of AC on the radioactivity concentration differences between reconstructed PET images in normal subjects and patients. Material and Methods: Five normal subjects and 35 patients with a known or suspected cancer underwent $^{18}F-FDG$ PET/CT. In each subject, attenuation corrected PET images using OSEM algorithm (28 subsets, 2 iterations) were reconstructed by 4 methods: CT-MAC, CT-SAC, Ge-MAC, and Ge-SAC. The physiological uptake in normal subjects and pathological uptake in patients were quantitatively compared between the PET images according to the source and type of AC. Results: The SUVs of physiological uptake measured in CT-MAC PET images were significantly higher than other 3 differently corrected PET images. Maximum SUVs of the 145 foci with abnormal FDG uptake in CT-MAC images were significantly highest among 4 differently corrected PET images with a difference of 2.4% to 5.1% (p<0.001). The SUVs of pathological uptake in Ge-MAC images were significantly higher than those in CT-SAC and Ge-MAC PET images (p<0.001). Conclusion: Quantitative radioactivity values were highest in CT-MAC PET images. The adoption of MAC may make a more contribution than the adoption of CT attenuation map to such differences.

• The Korean Journal of Nuclear Medicine
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• v.38 no.1
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• pp.52-61
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• 2004

Purpose: Cervical lymph node metastasis is the most important factor of the prognosis and therapeutic planning in head and neck cancer. With increasing interest of minimally invasive neck surgery, more accurate preoperative assessment of cervical lymph node becomes more essential. We evaluated the diagnostic accuracy of $^{18}F$ FDG-PET in the assessment of lymph node metastasis in patients with primary head and neck cancer and compared the results with those of CT/MRI. Materials and Methods: Thirty-two patients (M/F=27/5, $56{\pm}10yr$) with biopsy proven head and neck cancer (16 supraglottic cancer, 9 tongue cancer, 7 others) underwent FDG-PET and CT/MRI (25/7) within 1 month before neck dissection. Based on lymph node level, the diagnostic sensitivity and specificity of FDG PET and CT/MRI for the metastasis of cervical lymph node were compared. Results: Of 153 lymph node levels dissected in 32 patients, 32 lymph node levels of 19 patients were positive for metastasis by histopatholologic examination. The overall sensitivity and specificity of FDG-PET were 88% (28/32) and 93% (113/121), whereas those of CT/MRI were 56% (18/32) (p=0.002) and 92% (112/121), respectively. The diagnostic sensitivity and specificity of FDG-PET were different according to location of lymph node levels, and those of ipsilateral level 11 were lower than those of other levels. Conclusion: FDG-PET is more sensitive in detecting metastatic cervical lymph node in head and neck cancer than CT/MRI. FDG-PET might be useful in guiding the extent of neck dissection.

• The Korean Journal of Nuclear Medicine Technology
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• v.26 no.2
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• pp.32-36
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• 2022

Purpose There are reports that the COVID-19 vaccine causes false positive uptake of axillary lymph nodes. Therefore, this paper intends to evaluate the change in SUVmax of axillary lymph nodes with the period after the COVID-19 vaccination. Materials and Methods In 134 breast cancer patients who were tested for ¹⁸F-FDG PET/CT at Severance hospital, 3.7 MBq/kg of ¹⁸F-FDG was intravenously injected and scanned for 2 minutes per bed after 60 minutes. The equipment was Discovery 600 (GE Healthcare, MI, USA). The period was divided into four groups, 0 to 2 weeks, 3 to 6 weeks, 7 to 10 weeks, and 11 weeks or more. SUVmax was measured after checking the uptake of axillary lymph nodes on the ipsilateral side of vaccination and the Kruskal-Wallis test was performed using SPSS Statistics 28 (IBM Corp., Armonk, NY, USA). Results From 0 to 2 weeks groups to 11 weeks or more group, the average of SUVmax was measured in the order of 5.52, 2.85, 1.82, and 1.7. As a result of the Kruskal-Wallis test, there was a significant difference between 0 to 2 weeks group from all other groups (P < 0.05), and there was no significant difference between the remaining three groups. Conclusion The SUVmax of axillary lymph nodes decreased over the period after the COVID-19 vaccination and no significant difference was found after 3 weeks of vaccination. Therefore, it is recommended to record COVID-19 vaccination information before examination.

• Nuclear Medicine and Molecular Imaging
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• v.41 no.3
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• pp.263-264
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• 2007

Splenic metastasis from colon carcinoma are rare and usually occur in the presence of disseminated visceral metastasis. The liver is the most common site of metastatic spread from colon cancer. Several hypotheses have attempted to explain the low incidence of splenic metastasis. It should be difficult for colorectal cancer cells to reach the spleen through the portal venous system, in which the blood flow is usually from the spleen to the liver. Reticuloendothelial system or rhythmic contraction of the spleen may squeeze out the tumor in the spleen. The absence of afferent lymphatic to the spleen, phagocytic activity and humoral anticancer substances are considered to be other reason for low incidence of splenic metastasis. We report the case of $^{18}F-FDG$ PET/CT finding in a 70-year-old woman who develop isolated splenic metastasis of sigmoid colon cancer.

• Journal of radiological science and technology
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• v.30 no.3
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• pp.245-250
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• 2007

This research measured the shielding rates of apron 0.25 and 0.5 mmPb for X-ray energy in diagnosis radiation system and gamma-ray energy of $^{99m}Tc$-MDP and $^{18}F$-FDG. X-ray energies were measured on effective energy of $26.2{\sim}45.6\;keV$ when additional filtering plate of 0, 2 mmAl is used within the range of tube voltage $40{\sim}120\;kVp$, and at this time, apron 0.5 mmPb has shown about 5.5% of increase in its shielding rate over 0.25 mmPb at the highest quality. Besides, the aprons of the two types have shown high shielding rate of over 90% for direct X-ray and spatial dose rate. And, in case 0.25 and 0.5 mmPb aprons were used at 140keV of $^{99m}Tc$-MDP, the shielding effects were between 30 and 53%, and at high energy of 511 keV, $^{18}F$-FDG, the shielding effects of apron, $1.3{\sim}3.6%$, were very small.