• Tuberculosis and Respiratory Diseases
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• 제81권4호
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• pp.339-346
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• 2018

Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) is a standard procedure to evaluate suspicious lymph node involvement of lung cancer because computed tomography (CT) and $^{18}F$-fluorodeoxyglucose positron emission tomography-CT (PET-CT) have limitations in their sensitivity and specificity. There are a number of benign causes of false positive lymph node such as anthracosis or anthracofibrosis, pneumoconiosis, old or active tuberculosis, interstitial lung disease, and other infectious conditions including pneumonia. The purpose of this study was to evaluate possible causes of false positive lymph node detected in chest CT or PET-CT. Methods: Two hundred forty-seven patients who were initially diagnosed with lung cancer between May 2009 and December 2012, and underwent EBUS-TBNA to confirm suspicious lymph node involvement by chest CT or PET-CT were analyzed for the study. Results: Of 247 cases, EBUS-TBNA confirmed malignancy in at least one lymph node in 189. The remaining 58 patients whose EBUS-TBNA results were negative were analyzed. Age ${\geq}65$, squamous cell carcinoma as the histologic type, and pneumoconiosis were related with false-positive lymph node involvement on imaging studies such as chest CT and PET-CT. Conclusion: These findings suggest that lung cancer staging should be done more carefully when a patient has clinically benign lymph node characteristics including older age, squamous cell carcinoma, and benign lung conditions.

• 핵의학기술
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• 제26권2호
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• pp.32-36
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• 2022

코로나바이러스의 대유행으로 인하여 백신접종이 시작되었고 코로나 백신으로 인한 림프절병증의 여러사례가 발표되고 있으며, ¹⁸F-FDG PET/CT에서는 액와 림프절에 위양성 섭취를 유발한다는 보고가 있다. 이에 코로나 백신 접종 후 기간에 따른 접종 측 액와 림프절의 SUVmax의 변화 양상을 평가하고자 한다. 환자는 접종 후 기간을 0~2주, 3~6주, 7~10주, 11주 이상으로 4개 집단으로 나누었고 FDG를 3.7 MBq/kg을 주입하고 한 시간 뒤 1 bed 당 2분 동안 촬영했다. 장비는 Discovery 600 (GE Healthcare, MI, USA)을 사용하였다. 검사 후 핵의학 판독의가 육안평가를 진행하였고, 그 결과를 토대로 접종 측액와 림프절의 섭취 여부를 구분하였다. 그 후에 유방암 부위 반대 측 팔에 백신이 접종되었으며 그로 인해 섭취가 발생한 액와 림프절에 관심 영역을 그려 SUVmax를 측정하였다. 백신접종 후 기간이 지남에 따라 접종 측 액와 림프절에 섭취된 환자의 비율과 SUVmax는 감소하였다. 또한 4개 집단의 섭취된 액와 림프절의 SUVmax를 Kruskal-Wallis test를 한 결과 4개 집단 간 SUVmax에서 통계적으로 유의한 차이가 있었고(P<0.05) Mann-Whitney test로 사후 검정한 결과 0~2주는 다른 집단과 모두 유의한 차이가 있었으나(P<0.05) 나머지 3개 집단 간에는 유의한 차이가 없는 것을 알 수 있었다. 이러한 경향성은 참고자료로써 유용할 것으로 사료되며 PET/CT 검사 전 코로나 백신접종 정보를 기록하여 진행하는 것을 권고한다.

• 보건행정학회지
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• 제14권3호
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• pp.45-65
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• 2004

The rapid increase in PET devices and its utilization in Korea necessitates relevant health insurance policies based on scientific evidence, including economic evaluation of PET in clinical conditions. However, there is very little amount of evidence regarding PET, and the first step would be to establish research priorities to give a momentum for research and assure efficient use of research capacities. To this end, we conducted a two-round Delphi study, which produced stable consensus on about top 10 oncology indications for research, which included lymphoma staging, colorectal cancer recurrence/restaging, lung cancer staging, and other conditions. The results were largely consistent with current U.S. Medicare reimbursement indications and are expected to lead to relevant researches and evidence-based health policies on PET reimbursement and regulation.

• Asian Pacific Journal of Cancer Prevention
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• 제16권14호
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• pp.5599-5605
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• 2015

In oncology various imaging modalities play a crucial role in diagnosis, staging, restaging, treatment monitoring and follow up of various cancers. Stand-alone morphological imaging like computerized tomography (CT) and magnetic resonance imaging (MRI) provide a high magnitude of anatomical details about the tumor but are relatively dumb about tumor physiology. Stand-alone functional imaging like positron emission tomography (PET) and single photon emission tomography (SPECT) are rich in functional information but provide little insight into tumor morphology. Introduction of first hybrid modality PET/CT is the one of the most successful stories of current century which has revolutionized patient care in oncology due to its high diagnostic accuracy. Spurred on by this success, more hybrid imaging modalities like SPECT/CT and PET/MR were introduced. It is the time to explore the potential applications of the existing hybrid modalities, developing and implementing standardized imaging protocols and train users in nuclear medicine and radiology. In this review we discuss three existing hybrid modalities with emphasis on their technical aspects and clinical applications in oncology.

• Nuclear Medicine and Molecular Imaging
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• 제43권6호
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• pp.526-534
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• 2009

목적: 무증상 성인을 대상으로 시행된 PET과 PET/CT 검사 결과를 분석하여 이들 검사의 암 조기 진단을 위한 선별검사로서의 유용성을 평가하고자 하였다. 대상 및 방법: 1998년 3월부터 2008년 2월까지 서울 소재 1개 대학병원에서 건강검진 프로그램의 일부로 시행된 PET과 PET/CT 검사자 중 1년 이상 추적관찰이 이루어진 5,091명을 대상으로 하였다. PET과 PET/CT 시행 후 1년 이내에 암이 확진된 경우를 조사하여 PET과 PET/CT의 판독결과와 비교하고 민감도와 특이도를 평가하였으며, 판독에서 명확한 결론을 내기 어려워 추가 검사를 권고한 경우를 분석하였다. 결과: PET 또는 PET/CT 검사 시행 후 1년이내에 암을 진단 받은 경우는 총 86건으로 전체 조사 대상의 1.7%(86/5,091)였다. PET과 PET/CT 검사를 합친 전체검사의 민감도는 48.8%였으며 특이도는 81.1%였다. PET 단독검사의 민감도와 특이도는 각각 46.2%, 81.4% 였으며, PET/CT 단독 검사의 민감도와 특이도는 각각 75.0%, 78.5%였다. 판독에서 암이 의심되었던 경우와 판독에서 암이 의심되지 않았던 경우를 비교하여 보았으나 암부위, 조직학적 진단, 암 병기 등에서 두 군 사이에 통계학적으로 유의한 차이가 없었다. PET과 PET/CT에서 양성 혹은 악성의 의미 있는 병변이 의심되거나 양성 및 악성을 구분하기 어려워 추가 검사를 권고한 경우는 전체의 19.3%(981/5,091)였다. 이중에서 두경부 및 상부 위장관 부위에 대한 추가 검사를 권고한 경우가 가장 많았다. 결론: 무증상 성인의 건강검진에서 사용한 PET과 PET/CT 의 암 진단 정확도는 중간 정도로 평가되었다. PET과 PET/CT의 효용성을 높이기 위해서는 검사 대상집단의 연령이나 위험요인과 같은 임상적 특성을 고려해야 할 것이다. 또한 검사법과 판독 기술의 향상이 필요하며, 검사에 대한 충분한 이해를 바탕으로 수진자가 현명한 선택을 하도록 하여야 한다.

• 대한안전경영과학회지
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• 제17권1호
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• pp.111-117
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• 2015

When scanning PET/CT, dose not unwrinkle gastric folds can be difficult to diagnose gastric cancer. In this study, we use an blowing agent to evaluate the extension the stomach and usefulness of it. The study enrolled 30 patients who patient with uptake in stomach between January and February 2013. Stomach extension was described as the vertical length of the Water drink group was $61.7{\pm}9.7mm$, horizontal length was $102.5{\pm}17.6mm$ and the vertical length of the Blowing agent group was $74.1{\pm}10.7mm$, horizontal length was $101.5{\pm}14.8mm$ in transverse section. Stomach extension was described as the vertical length of the Water drink group was $109.3{\pm}18.8mm$, horizontal length was $62.7{\pm}18.4mm$ and the vertical length of the Blowing agent group was $123.1{\pm}23.1mm$, horizontal length was $87.6{\pm}14.9mm$ in coronal section. Water drink group SUV decreased 35% and Blowing agent group SUV decreased 56%. Blowing agent group extension was similar or superior than water drink group. Therefore, when using a blowing agent will be able to help clinical.

• 대한디지털의료영상학회논문지
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• 제13권1호
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• pp.33-38
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• 2011

Now a days, there's many change over for PACS among the most of hospital and it standard for DICOM 3.0. These kind of using of DICOM 3.0 improves increasing of medical imaging exchange and service for patient. However, there's some problems of compatibility caused during carry out CD and DVD from hospital. For this reason, this thesis analyzed patients image targeting those storages requested to hospitals in Seoul by using Validation Toolkit which is recommended from KFDA. The analyze type is like this. Make 100 data, total 500, each of MRI CT Plain x-ray Ultrasound PET-CT images and analyzed type of error occurred and loyalty of information. If express percentage of error occurred statistically, we can get a result as follows MRI 5%, Plain x-ray 11%, CT 18%, US 25%, PET-CT 30%. The reson why percentage of error occurred in PET-CT is because of imperfective support and we could notice that we weren't devoted to information. Even though, PET-CT showed highest percentage of error occurred, currently DICOM data improved a lot compare to past. Moreover, it should be devoted to rule of IHE TOOL or DICOM. In conclusion, we can help radiographer to analyze information of image by providing clues for solving primary problem and further more, each of PACS company or equipment company can enhance fidelity for following standard of image information through realizing the actual problem during transfer of image information.

• Investigative Magnetic Resonance Imaging
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• 제23권2호
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• pp.100-113
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• 2019

Sarcoidosis is a multisystem disease characterized by noncaseating granulomas. Cardiac involvement is known to have poor prognosis because it can manifest as a serious condition such as the conduction abnormality, heart failure, ventricular arrhythmia, or sudden cardiac death. Although early diagnosis and early treatment is critical to improve patient prognosis, the diagnosis of CS is challenging in most cases. Diagnosis usually relies on endomyocardial biopsy (EMB), but its diagnostic yield is low due to the incidence of patchy myocardial involvement. Guidelines for the diagnosis of CS recommend a combination of clinical, electrocardiographic, and imaging findings from various modalities, if EMB cannot confirm the diagnosis. Especially, the role of advanced imaging such as cardiac magnetic resonance (CMR) imaging and positron emission tomography (PET), has shown to be important not only for the diagnosis, but also for monitoring treatment response and prognostication. CMR can evaluate cardiac function and fibrotic scar with good specificity. Late gadolinium enhancement (LGE) in CMR shows a distinctive enhancement pattern for each disease, which may be useful for differential diagnosis of CS from other similar diseases. Effectively, T1 or T2 mapping techniques can be also used for early recognition of CS. In the meantime, PET can detect and quantify metabolic activity and can be used to monitor treatment response. Recently, the use of a hybrid CMR-PET has introduced to allow identify patients with active CS with excellent co-localization and better diagnostic accuracy than CMR or PET alone. However, CS may show various findings with a wide spectrum, therefore, radiologists should consider the possible differential diagnosis of CS including myocarditis, dilated cardiomyopathy (DCM), hypertrophic cardiomyopathy, amyloidosis, and arrhythmogenic right ventricular cardiomyopathy. Radiologists should recognize the differences in various diseases that show the characteristics of mimicking CS, and try to get an accurate diagnosis of CS.

• Asian Pacific Journal of Cancer Prevention
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• 제15권18호
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• pp.7821-7824
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• 2014

Background: We investigated the correlation between standardized uptake value (SUVmax), tumor size and Fuhrman grade in patients with renal cell carcinoma (RC). Materials and Methods: We retrospectively analyzed the data of 54 patients with clear cell renal cell carcinoma histopathologically diagnosed who underwent fluorine-18 fluoro-2 deoxyglucose positron emission tomography/computed tomography (F-18 FDG PET/CT) between January 2005 and March 2014. Results: Avarage tumor sizes were $5.64{\pm}1.85$, $6.85{\pm}2.24$ and $7.98{\pm}2.45$ in low, medium and high SUVmax groups, respectively. The Spearman's correlation coefficient between the tumor size and SUVmax was 0.385 (p=0.004) and between the Fuhrman grade and SUVmax was 0.578 (p<0.001). Conclusions: SUVmax appears highly correlated with tumor size and Fuhrman grade in patients with histopathologically confirmed clear cell RC. Multicenter studies are needed to provide larger series for more accurate results.

• Nuclear Medicine and Molecular Imaging
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• 제42권5호
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• pp.410-413
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• 2008

A 56 years old woman referred to our hospital with dysphagia and epigastric soreness. Gastroendoscopy revealed huge submucosal tumor with ulceration extending from distal esophagus to lesser curvature of stomach. Subsequent computed tomography(CT) demonstrated soft tissue mass encircling distal esophagus, and 18F-FDG PET/CT demonstrated intense $^{18}F-FDG$ accumulation in it. Finally this case was diagnosed as esophageal leiomyoma based on pathologic evaluation of the surgical specimen.