• Title/Summary/Keyword: Liver CT 검사

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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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Diagnostic Accuracy of PET and MR for Detecting Liver Metastasis from Colorectal Cancer (대장-직장암의 간전이에서 FDG PET과 MR의 진단 성능)

  • Park, Eun-Kyung;Kang, Won-Jun;Eo, Jae-Seon;Lee, Dong-Soo;Chung, June-Key;Lee, Myung-Chul
    • Nuclear Medicine and Molecular Imaging
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    • v.40 no.5
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    • pp.249-256
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    • 2006
  • Purpose: Although computed tomography (CT) is widely used for diagnosing liver metastasis from colorectal cancer, diagnostic accuracy of CT is not satisfactory. Magnetic resonance (MR) imaging and F-18 FDG PET has been reported to be superior to CT. However, studies on direct comparison of PET and MR are scarce. We compared the diagnostic accuracy of FDG PET and MR in detecting liver metastasis from colorectal cancer. Materials and Methods: Among 363 colorectal cancer patients who underwent F-18 FDG PET (ECAT, Siemens-CTI, Knoxville; Gemini, Philips, Milpitas, U.S.), 26 patients (M:F=17:9, age=$62{\pm}11$) underwent MR to evaluate suspicious metastatic liver lesions. Finally, 35 liver lesions detected by CT from 26 patients were enrolled for analysis. PET and MR results were compared with pathologic reports, clinical findings or follow-up results. Results: Of the 35 lesions, 18 lesions (51.4%) were diagnosed as liver metastases, while remaining 17 (48.6%) as benign. The sensitivity and the specificity of PET were 94.4% and 94.1%, respectively, compared to 100% and 82.4% for MR. MR and PET was concordant in 30 lesions (85.7%: 17 metastatic (94.4%) and 13 benign (76.5%) lesions. ROC curve analysis revealed maximal SUV of 3.1 as the optimum standard in differentiating metastatic from benign liver lesions (AUC=0.897, p<0.001, sensitivity 83.3%, specificity 94.1%). For small lesions less than 1 cm ln diameter (n=20), diagnostic accuracy of PET was comparable to that of MR. Conclusion: F-18 FDG PET showed good diagnostic performance in detecting liver metastasis from colorectal cancer, which was comparable to MR.

A Case with Unusual Manifestation of Multiple Amebic Liver Abscesses by Coinfection with Clonorchis Sinensis - Diagnosed by CT-guided Fine Needle Aspiration - (간흡충 감염에 의한 간내담도의 낭성변화와 동반된 아메바성 농양 - 세침흡인 세포학적 검사로 진단된 1례 -)

  • Kim, Sung-Sook;Kim, Jung-Ran;Lee, Hyeon-Kyeng;Lee, Sung-Hee;Han, Dong-Sun;Hong, Sung-Tae
    • The Korean Journal of Cytopathology
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    • v.4 no.2
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    • pp.176-180
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    • 1993
  • Clonorchiasis is common in Korea. The coinfection of amebic abscess with clonorchiasis is not rare in endemic areas. The coinfection may influence on its manifestations each other. We experienced a human case with unusal manifestation of amebic liver abscess associated with coinfection by Clonorchisis sinensis. The case was an 80-year-old female. She lived in Yongil-gun, Kyongsangbuk-do, Korea, She had multiple amebic abscess cavities in the liver, one of which subsided spontaneously and others newly appeared. She was diagnosed by CT guided aspiration of the cyst, which revealed trophozoites of ameba and eggs of C. sinensis. She was treated with praziquantel and metronidazale and was cured.

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CT Findings of Hepatic Metastasis from Hepatoid Adenocarcinoma of the Rectum Mimicking Hepatocellular Carcinoma: A Case Report (간세포암으로 오인된 직장에 발생한 간양 선암종의 간전이 CT 소견: 증례 보고)

  • Tae Hoon Lim;Jae Woon Kim;Min Jong Kim
    • Journal of the Korean Society of Radiology
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    • v.85 no.2
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    • pp.409-414
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    • 2024
  • Hepatoid adenocarcinoma (HAC) is a rare form of adenocarcinoma that is diagnosed based on immuno-histochemical findings reminiscent of hepatocellular carcinoma (HCC). The clinical characteristics of HAC include increased levels of serum alpha-fetoprotein and a poor prognosis due to early liver metastasis. In particular, diagnosing liver metastasis of HAC can be challenging owing to radiological findings similar to those of HCC. Although HAC can occur in various organs, the stomach is the most common site. We present the case of a 64-year-old femalewho presented with multiple tumors in the liver. During subsequent examination, rectal cancer was identified and diagnosed as HAC through a biopsy. Herein, we report this case along with a literature review.

Long-term Survival of Recurrent Pancreatic Cancer Treated with Tumorectomy and Stereotactic Body Radiation Therapy (수술 후 재발한 췌장암에서 종양절제술과 정위적 체부 방사선치료로 장기간 생존을 보인 환자)

  • Jong Hwa Won;Ji Kon Ryu;Min Su You
    • Journal of Digestive Cancer Research
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    • v.6 no.2
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    • pp.73-77
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    • 2018
  • A 70-year-old female diagnosed with pancreatic ductal adenocarcinoma was treated by pylorus-preserving pancreaticoduodenectomy (PPPD) and adjuvant concurrent chemoradiotherapy with 5-fluorouracil. Pancreatic ductal adenocarcinoma pT3N0 (stage IIA) was pathologically confirmed. Abdominal computed tomography (CT) findings 14 months after PPPD showed 10 mm sized solitary liver metastasis in segment 3. After 12 cycles of gemcitabine and 9 cycles of capecitabine plus oxaliplatin, the metastatic nodule increased in size to 27 mm. Tumorectomy at segment 3 of liver was done. 25 months after tumorectomy, chest CT showed 23 mm sized cavitary nodule in right upper lobe of lung. The result of percutaneous biopsy favored metastatic adenocarcinoma. Two sets of stereotactic body radiation therapy were done and the patient has survived without further disease progression for 6 years after initial diagnosis. This case suggests that selected population of recurrent pancreatic cancer patients with solitary liver or pulmonary metastasis can be treated by resection of metastatic site and ablative therapies.

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Familial Case of Visceral Larval Migrans of Toxocara Canis after Ingestion of Raw Chicken Liver (닭 간 생식 후 가족에서 집단으로 발생한 개회충에 의한 내장 유충 이행증 1예)

  • Park, Min-Su;Ahn, Young-Joon;Moon, Kyung-Rye
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.13 no.1
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    • pp.70-74
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    • 2010
  • We report a familial case of visceral larva migrans of Toxocara canis after eating raw chicken liver. A 9-year-old female ate raw chicken liver with her father and older brother and was admitted to the hospital with periumbilical pain, a mild fever, and headache. The total peripheral eosinophil count was 9,884/$mm^3$ and the total lgE concentration was 2,317 IU/dL. Chest and abdominal computed tomography (CT) scans demonstrated multiple, poorly-defined, small, nodular lesions scattered in the liver and lung parenchyma. Toxocara ELISA and Western blot tests were positive in the patient, and her father and brother. A liver biopsy revealed extensive eosinophilic infiltrations in the portal and lobular areas. She took albendazole for 5 days and was discharged in good condition. These results suggest that clinicians should consider foodborne toxocariasis in patients with multiple, small nodules in the liver and lung parenchyma with eosinophilia and a history of raw meat ingestion.

Dose Reduction and Image Quality Assessment of the CareDose 4D Technique on Abdomen Liver Computed Tomography (복부 간 CT 검사에서 CareDose 4D 사용에 따른 선량 감소 및 화질 평가)

  • Seok, Jong-Min;Jeon, Woo-Jin;Park, Young-Joon;Lee, Jin
    • Journal of the Korean Society of Radiology
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    • v.11 no.3
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    • pp.109-115
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    • 2017
  • The purpose of this study was to evaluate the clinical efficacy of 128 MDCT (multi-detector computed tomography) for reducing the CareDose 4D dose and comparing the image quality with the fixed tube current technique. For this purpose, we conducted the phantom and clinical studies to evaluate the exposure dose and image of the subject before and after applying the CareDose 4D system in abdominal examination using 128 MDCT. In the phantom study, ROI (Region of interest) was located at the center, 3, 6, 9, 12 o'clock, into two groups: group A without CareDose 4D and Group B applied were measured. In the clinical study, ROI was located at the liver 8 segments, divided into two groups too. The measured items were CT number, noise, and dose length product (DLP) dose. The result of CTDIvol (CT Dose Index volume) measurements in phantom and clinical studies were lower than those before CareDose 4D application, and dose and effective dose were also measured lower (p<.05). There was no difference in CT number before and after application (p>.05). In conclusion, using CareDose 4D, we can obtain optimal image information without deteriorating image quality while reducing patient dose.

A Study on the Possibility of Pancreas Detection through Extraction of Effective Atomic Number using a Simulation such as Dual-energy CT (이중에너지 CT와 같은 시뮬레이션을 이용한 유효원자번호 추출을 통한 췌장 검출 가능성 연구)

  • Son, Ki-Hong;Lee, Soo-Yeul;Chung, Myung-Ae;Kim, Dae-Hong
    • Journal of the Korean Society of Radiology
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    • v.16 no.5
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    • pp.537-543
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    • 2022
  • The purpose of this simulation study was to evaluate the possibility of pancreas detection through effective atomic number information using dual-energy computed tomography(CT). The effective atomic number of 10 tissue-equivalent materials were estimated through stoichiometric calibration. For stoichiometric calibration, HU values at low-energy (80 kV) and high-energy (140 kV) for 10 tissue-equivalent materials were used. Based on this method, the effective atomic number image of the tissue-equivalent material was extracted through an iterative algorithm. According to the results, the attenuation ratio in accordance with the effective atomic number was estimated to have an R2 value of 0.9999, and the effective atomic number of Pancreas, Water, Liver, Blood, Spongiosa, and Cortical bone was overall within 1% accuracy compared to the theoretical value. Conventional pancreatic cancer examination uses a contrast medium, so there is a possibility of potential side effects of the contrast medium. In order to solve this problem, it is thought that it will be possible to contribute to an accurate and safe examination by extracting the effective atomic number using dual-energy CT without contrast enhancement. Based on this study, future research will be conducted on the detection of pancreatic cancer using the HU value of pancreatic cancer based on clinical images.

Postoperative Imaging Findings of Biliary Atresia (담도폐쇄증의 수술 후 영상 소견)

  • Jisun Hwang;Hee Mang Yoon;Pyeong Hwa Kim;Jung-Man Namgoong;Seak Hee Oh;Ah Young Jung;Jin Seong Lee;Young Ah Cho
    • Journal of the Korean Society of Radiology
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    • v.83 no.5
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    • pp.1014-1031
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    • 2022
  • The Kasai portoenterostomy is the first-line treatment for the restoration of the flow of bile to the small intestine in patients with biliary atresia. Various complications can occur after Kasai portoenterostomy, including ascending cholangitis, biliary cirrhosis, and portal hypertension. Of these potential complications, ascending cholangitis in the most common. In cases of patients having uncontrolled complications due to progressive liver cirrhosis, portal hypertension, or progressive hyperbilirubinemia, liver transplantation is the indicated as treatment plan. Lifelong follow-up, particularly involving imaging studies, is important for the identification of various complications arising from biliary atresia after Kasai portoenterostomy. Additionally, imaging studies play a crucial role in the evaluation of potential liver donors and recipients. US is a key imaging modality utilized in the management of patients who undergo Kasai portoenterostomy, while CT and MRI are imperative to obtaining an accurate diagnosis.

The Effect of PET/CT Images on SUV with the Correction of CT Image by Using Contrast Media (PET/CT 영상에서 조영제를 이용한 CT 영상의 보정(Correction)에 따른 표준화섭취계수(SUV)의 영향)

  • Ahn, Sha-Ron;Park, Hoon-Hee;Park, Min-Soo;Lee, Seung-Jae;Oh, Shin-Hyun;Lim, Han-Sang;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.77-81
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    • 2009
  • Purpose: The PET of the PET/CT (Positron Emission Tomography/Computed Tomography) quantitatively shows the biological and chemical information of the body, but has limitation of presenting the clear anatomic structure. Thus combining the PET with CT, it is not only possible to offer the higher resolution but also effectively shorten the scanning time and reduce the noises by using CT data in attenuation correction. And because, at the CT scanning, the contrast media makes it easy to determine a exact range of the lesion and distinguish the normal organs, there is a certain increase in the use of it. However, in the case of using the contrast media, it affects semi-quantitative measures of the PET/CT images. In this study, therefore, we will be to establish the reliability of the SUV (Standardized Uptake Value) with CT data correction so that it can help more accurate diagnosis. Materials and Methods: In this experiment, a total of 30 people are targeted - age range: from 27 to 72, average age : 49.6 - and DSTe (General Electric Healthcare, Milwaukee, MI, USA) is used for equipment. $^{18}F$- FDG 370~555 MBq is injected into the subjects depending on their weight and, after about 60 minutes of their stable position, a whole-body scan is taken. The CT scan is set to 140 kV and 210 mA, and the injected amount of the contrast media is 2 cc per 1 kg of the patients' weight. With the raw data from the scan, we obtain a image showing the effect of the contrast media through the attenuation correction by both of the corrected and uncorrected CT data. Then we mark out ROI (Region of Interest) in each area to measure SUV and analyze the difference. Results: According to the analysis, the SUV is decreased in the liver and heart which have more bloodstream than the others, because of the contrast media correction. On the other hand, there is no difference in the lungs. Conclusions: Whereas the CT scan images with the contrast media from the PET/CT increase the contrast of the targeted region for the test so that it can improve efficiency of diagnosis, there occurred an increase of SUV, a semi-quantitative analytical method. In this research, we measure the variation of SUV through the correction of the influence of contrast media and compare the differences. As we revise the SUV which is increasing in the image with attenuation correction by using contrast media, we can expect anatomical images of high-resolution. Furthermore, it is considered that through this trusted semi-quantitative method, it will definitely enhance the diagnostic value.

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