• Title/Summary/Keyword: FDG PET-CT

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Diagnosis of Graft Infection Using FDG PET-CT

  • Shim, Hun-Bo;Sung, Ki-Ick;Kim, Wook-Sung;Lee, Young-Tak;Park, Pyo-Won;Jeong, Dong-Seop
    • Journal of Chest Surgery
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    • v.45 no.3
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    • pp.189-191
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    • 2012
  • Graft infections after aortic replacement are a rare, but severe complication. Because surgical removal of the infection source is essential, an accurate diagnosis is required to prevent unnecessary treatment. Both of the patients described herein were diagnosed with graft infections using dual-modality positron emission tomography-computed tomography; one patient was a false-positive, and the other was confirmed with an infection.

Nuclear Medicine Imaging Diagnosis in Infectious Bone Diseases (감염성 골질환의 핵의학 영상진단)

  • Choi, Yun-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.4
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    • pp.193-199
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    • 2006
  • Infectious and inflammatory bone diseases include a wide range of disease process, depending on the patient's age, location of infection, various causative organisms, duration from symtom onset, accompanied fracture or prior surgery, prosthesis insertion, and underlying systemic disease such as diabetes, etc. Bone infection may induce massive destruction of bones and joints, results in functional reduction and disability. The key to successful management is early diagnosis and proper treatment. Various radionuclide imaging methods including three phase bone scan, Ga-67 scan, WBC scan, and combined imaging techniques such as bone/Ga-67 scan, WBC/bone marrow scan add complementary role to the radiologic imaging modalities including plain radiography, CT and MRI. F-18 FDG PET imaging also has recently been introduced in diagnosis of infected prosthesis and chronic active osteomyelitis. Selection of proper nuclear medicine imaging method will improve the diagnostic accuracy of infections and inflammatory bone diseases, based on understading of pathogenesis and radiologic imaging findings.

Paraneoplastic demyelination in the brain presenting as a clinically occult non-Hodgkin's lymphoma

  • Son, Hyoshin;Choi, Jongsuk;Kim, Sung Un;Park, Kyung Seok
    • Annals of Clinical Neurophysiology
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    • v.21 no.2
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    • pp.108-112
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    • 2019
  • Non-Hodgkin's lymphoma (NHL) may initially present with atypical neurological manifestations, including paraneoplastic neurological syndromes. Herein, we report the case showing an initial manifestation of systemic NHL with paraneoplastic demyelination in the brain that initially mimicked the symptoms of stroke, seizure, and brain tumor. A high index of suspicion and timely diagnostic workup is required to prevent diagnostic delay and commence proper management of the condition. In this situation, a whole-body FDG PET/CT could be useful to screen for occult malignancy.

Primary Diffuse Large B-Cell Lymphoma of the Seminal Vesicle: a Case Report

  • Kwag, Kyung Su;Jang, Suk Ki;Yeon, Jae Woo;Kwon, Kye-Won;Son, Jeong Hwan;Kim, Hyuk Jung
    • Investigative Magnetic Resonance Imaging
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    • v.20 no.4
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    • pp.259-263
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    • 2016
  • Primary diffuse large B-cell lymphoma of the seminal vesicle is an extremely rare disorder, with only two cases reported in the English literature. Here, we present imaging findings of a case of primary diffuse large B-cell lymphoma of the seminal vesicle. On transrectal ultrasonography, the mass presented as a 3.0-cm-sized heterogeneous, hypoechoic lesion in the right seminal vesicle. Computed tomography (CT) revealed a mass with rim-like enhancement in the right seminal vesicle. On magnetic resonance imaging (MRI), the tumor showed iso-signal intensity on T1-weighted images and heterogeneously intermediate-high signal intensity on T2-weighted images. The tumor showed rim-like and progressive enhancement with non-enhancing portion on dynamic scanning. Diffusion restriction was observed in the mass. On fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET/CT) imaging, a high standardized uptake value (maxSUV, 23.5) by the tumor was noted exclusively in the right seminal vesicle.

Usefulness of Stomach Extension after Drinking Orange Juice in PET/CT Whole Body Scan (PET/CT 전신 영상에서 오렌지 주스(Orange Juice)를 이용한 위장 확장 영상의 유용성)

  • Cho, Seok-Won;Chung, Seok;Oh, Shin-Hyun;Park, Hoon-Hee;Kim, Jae-Sam;Lee, Chang-Ho
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.86-92
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    • 2009
  • Purpose: The PET/CT has a clear distinction on the lesion of the functional image by adding anatomical information. It also could reduce the examination time using CT data as the attenuation-correction. When the stomach was contracted from a fast, it could bring a misinterpretation of the cancer of the lesion with a presence of physiological $^{18}F$-FDG uptake in stomach and it occasionally would bring an additional scan to confirm. To complement this shortcoming, the method that the patients had water before the examination to extend the stomach had been attempted. However, a short excretion time of the stomach did not give sufficiently extended image of the stomach. Then the patients had additional water and had the examination again. Therefore, the noticed fact is that the stomach excretion time depends on calories, protein content, and the level of carbohydrate. In this study, we use an orange juice to evaluate the extension of the stomach and usefulness of it. Materials and Methods: PET/CT scan were obtained on total 150 of patient from February 2008 to October2008, There were 3 groups in this study and each group had 50 patients. First group drank nothing, Second group drank water and third group drank orange juice. The patients (man 25, female 25) not drinking are the age of 30~71 years old (average: 54), the patients (man: 25, female: 25) drinking water (400 cc) are the age of 28~71 years old (average: 54) and the patients (man: 25, female: 25) drinking orange juice (400 cc) are the age of 32~74 years old (average: 56). The patients were fasted in 6-8 hours before the test, the patients were not diabetic. $^{18}F$-FDG 370~555 MBq were injected intravenously. The patients were in stable position for 1 hour, than the image was obtained. The patients drank water and other patients drank orange juice before Whole body scan. The image scan started from mid-femur to skull base. The emission scan acquired for three minutes per bed and the images were reconstructed. Stomach extension analysis is measured from vertical and horizontal length. Results: Stomach Extension was described as the vertical length of the Non Drink Group was $1.20{\pm}0.50\;cm$, horizontal length was $1.4{\pm}0.53\;cm$, the vertical length of the Water Drink Group was $1.67{\pm}0.63\;cm$, horizontal length was $1.65{\pm}0.77\;cm$, the vertical length of Orange juice Drink Group was $3.48{\pm}0.77\;cm$, horizontal length was $3.66{\pm}0.77\;cm$ in coronal image. Stomach Extension was described the vertical length of the Non Drink Group was $2.03{\pm}0.62\;cm$, horizontal length was $1.69{\pm}0.68\;cm$, the vertical length of Water Drink Group was $5.34{\pm}1.62\;cm$, horizontal length was $2.45{\pm}0.72\;cm$, the vertical length of Orange juice Drink Group was $7.74{\pm}1.62\;cm$, horizontal length was $3.57{\pm}0.77\;cm$ in transverse image. The Stomach Extension has specific differences (p<0.001). The SUVs shows the Non Drink Group were measured as Liver $2.52{\pm}0.42$, Lung $0.51{\pm}0.14$, the Water Drink Group were measured as Liver $2.47{\pm}0.38$, Lung $0.50{\pm}0.14$, Orange juice Drink Group were measured as Liver $2.47{\pm}0.38$, Lung $0.50{\pm}0.14$. The SUVs did not have specific differences (p>0.759). Conclusions: There was not a large difference of SUV in three groups. When the patients drank Orange juice and water, the range extension of stomach was higher than without drinking nothing and it was possible to acquire fully extended images. Therefore, it will be possible that unnecessary additional stomach scans will be reduced by drinking orange juice before the examination so that the patients' claim from uncomfortable and long period of fast will be minimized.

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The Evaluation of Reconstruction Method Using Attenuation Correction Position Shifting in 3D PET/CT (PET/CT 3D 영상에서 감쇠보정 위치 변화 방법을 이용한 영상 재구성법의 평가)

  • Hong, Gun-Chul;Park, Sun-Myung;Jung, Eun-Kyung;Choi, Choon-Ki;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.172-176
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    • 2010
  • Purpose: The patients' moves occurred at PET/CT scan will cause the decline of correctness in results by resulting in inconsistency of Attenuation Correction (AC) and effecting on quantitative evaluation. This study has evaluated the utility of reconstruction method using AC position changing method when having inconsistency of AC depending on the position change of emission scan after transmission scan in obtaining PET/CT 3D image. Materials and Methods: We created 1 mL syringe injection space up to ${\pm}2$, 6, 10 cm toward x and y axis based on central point of polystyrene ($20{\times}20110$ cm) into GE Discovery STE16 equipment. After projection of syringe with $^{18}F$-FDG 5 kBq/mL, made an emission by changing the position and obtained the image by using AC depending on the position change. Reconstruction method is an iteration reconstruction method and is applied two times of iteration and 20 of subset, and for every emission data, decay correction depending on time pass is applied. Also, after setting ROI to the position of syringe, compared %Difference (%D) at each position to radioactivity concentrations (kBq/mL) and central point. Results: Radioactivity concentrations of central point of emission scan is 2.30 kBq/mL and is indicated as 1.95, 1.82 and 1.75 kBq/mL, relatively for +x axis, as 2.07, 1.75 and 1.65 kBq/mL for -x axis, as 2.07, 1.87 and 1.90 kBq/mL for +y axis and as 2.17, 1.85 and 1.67 kBq/mL for -y axis. Also, %D is yield as 15, 20, 23% for +x axis, as 9, 23, 28% for -x axis, as 12, 21, 20% for +y axis and as 8, 22, 29% for -y axis. When using AC position changing method, it is indicated as 2.00, 1.95 and 1.80 kBq/mL, relatively for +x axis, as 2.25, 2.15 and 1.90 kBq/mL for -x axis, as 2.07, 1.90 and 1.90 kBq/mL for +y axis, and as 2.10, 2.02, and 1.72 kBq/mL for -y axis. Also, %D is yield as 13, 15, 21% for +x axis, as 2, 6, 17% for -x axis, as 9, 17, 17% for +y axis, and as 8, 12, 25% for -y axis. Conclusion: When in inconsistency of AC, radioactivity concentrations for using AC position changing method increased average of 0.14, 0.03 kBq/mL at x, y axis and %D was improved 6.1, 4.2%. Also, it is indicated that the more far from the central point and the further position from the central point under the features that spatial resolution is lowered, the higher in lowering of radioactivity concentrations. However, since in actual clinic, attenuation degree increases more, it is considered that when in inconsistency, such tolerance will be increased. Therefore, at the lesion of the part where AC is not inconsistent, the tolerance of radioactivity concentrations will be reduced by applying AC position changing method.

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The Optimization of Reconstruction Method Reducing Partial Volume Effect in PET/CT 3D Image Acquisition (PET/CT 3차원 영상 획득에서 부분용적효과 감소를 위한 재구성법의 최적화)

  • Hong, Gun-Chul;Park, Sun-Myung;Kwak, In-Suk;Lee, Hyuk;Choi, Choon-Ki;Seok, Jae-Dong
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.13-17
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    • 2010
  • Purpose: Partial volume effect (PVE) is the phenomenon to lower the accuracy of image due to low estimate, which is to occur from PET/CT 3D image acquisition. The more resolution is declined and the lesion is small, the more it causes a big error. So that it can influence the test result. Studied the optimum image reconstruction method by using variation of parameter, which can influence the PVE. Materials and Methods: It acquires the image in each size spheres which is injected $^{18}F$-FDG to hot site and background in the ratio 4:1 for 10 minutes by using NEMA 2001 IEC phantom in GE Discovey STE 16. The iterative reconstruction is used and gives variety to iteration 2-50 times, subset number 1-56. The analysis's fixed region of interest in detail part of image and compute % difference and signal to noise ratio (SNR) using $SUV_{max}$. Results: It's measured that $SUV_{max}$ of 10 mm spheres, which is changed subset number to 2, 5, 8, 20, 56 in fixed iteration to times, SNR is indicated 0.19, 0.30, 0.40, 0.48, 0.45. As well as each sphere's of total SNR is measured 2.73, 3.38, 3.64, 3.63, 3.38. Conclusion: In iteration 6th to 20th, it indicates similar value in % difference and SNR ($3.47{\pm}0.09$). Over 20th, it increases the phenomenon, which is placed low value on $SUV_{max}$ through the influence of noise. In addition, the identical iteration, it indicates that SNR is high value in 8th to 20th in variation of subset number. Therefore, to reduce partial volume effect of small lesion, it can be declined the partial volume effect in iteration 6 times, subset number 8~20 times, considering reconstruction time.

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Usefulness of wearing pocket dosimeter in nuclear medicine (핵의학 영상검사에서 Pocket dosimeter 착용의 유용성 평가)

  • Kim, Young-Bin;Lee, Eun-Ji;Kim, Kun-Jae
    • The Korean Journal of Nuclear Medicine Technology
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    • v.15 no.1
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    • pp.25-28
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    • 2011
  • Purpose: The aim of study is to find accuracy of pocket dosimeter in measuring exposed dose in compared with survey meter and to compare exposed dose according as Nuclear medicine exams. Materials and Method: First, radiation dose to point source(185 MBq,370 MBq, ${\ldots}$, 1665 MBq, 1850 MBq) were measured in using a pocket dosimeter and a survey meter. Second, radiation dose to 12 patients injected $^{18}F$-FDG 370 MBq were measured in using a pocket dosimeter and a survey meter. Third, radiation dose to 10 patients injected $^{99m}Tc$-DPD 925 MBq were measured in using a pocket dosimeter and a surveymeter. Result: The average is $70.12{\pm}39.36{\mu}Sv/h$ in measurement of point source with Surveymeter and $5{\pm}3.06{\mu}Sv$ in measurement of point source with Pocket dosimeter. The average is $25.04{\pm}6.16{\mu}Sv/h$ in measurement of PET/CT patients with Surveymeter and $2.41{\pm}0.51{\mu}Sv$ in measurement of PET/CT with Pocket dosimeter. The average is $8.58{\pm}0.96{\mu}Sv/h$ in measurement of Bone Scan patients with Surveymeter and $1{\mu}Sv$ in measurement of Bone Scan patients with Pocket dosimeter. Significant difference found between Survey meter value and Pocket dosimeter value in all experimentation (p<0.001). Conclusion: Accoring to rusult Wearing Pocket dosimeter is usefulnee in manerage of exposed dose in nucler medicine exams.

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Comparing the Change in SUVmax Over Time by the Type of Ductal Breast Carcinoma (유방암 환자 중 유관에서 발병되는 암의 종류(IDC와 DCIS)별 시간경과에 따른 SUVmax 변화에 대한 비교)

  • Hyoung, Mi-Jin;Kim, Jeong Nip;Moon, Pyeong Soo;Kim, Kil Hwan
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.1
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    • pp.140-144
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    • 2014
  • Purpose: The recent surge in breast carcinoma patients is reported in a variety of statistics. Breast cancer occurs mainly from duct and lobulus: 85% is from the breast ducts. The present study is aimed to distinguish the difference in $SUV_{max}$ changing over time by identifying the type of cancers attacking from the duct. Materials and Methods: The subjects of the study are 291 female breast cancer patients who have visited the present PET/CT center from July 1, 2012 to July 23, 2013. Based on the pathological results, 248 IDC (invasive ductal carcinoma) patients and 43 DCIS (ductal carcinoma in situ) patients were selected. In the same manner as the general PET/CT scan (3.7 MBq/Kg), F-FDG was injected, followed by the primary test (Routine tests) after 1 hr, and the secondary test (Delay test) after another hr. $SUV_{max}$ was measured after setting ROI in the lesion based on the data from the two tests. Results: As the comparative result of the change in the lesion $SUV_{max}$ between the two groups, IDC group's $SUV_{max}$ showed M=7.11 and SD=5.405 in the primary test and increased M=7.11 and SD=5.405 in the secondary test (P<0.05); DCIS group's $SUV_{max}$ showed M=2.739, SD=1.229 in the primary test and increased M=2.614, SD=1.470 in the secondary test (P<0.05). Conclusion: As the comparative result of $SUV_{max}$ over time between the groups, IDC showed increased $SUV_{max}$ in the secondary test (Delay test) compared to the primary test (Routine test) (P=0.000); DCIS showed decreased $SUV_{max}$ in the secondary test (Delay test) compared to the primary test (Routine test) (P=0.039). It was confirmed through this study that the change in $SUV_{max}$ has occurred over time by the type of breast cancer (IDC or DCIS) occurring from the breast ducts. However, the onset of breast cancers (ILC, LCIS) from the lobulus was not discussed due to the lack of samples. Future research on the breast cancers from the lobulus is suggested.

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