• Title/Summary/Keyword: Pet Hospital

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FDG-PET/CT Complements Bone Scan with Respect to the Detection of Skip Metastasis of Osteosarcoma: A Case Report (골육종의 도약전이 진단에서 골스캔의 보완검사로서의 FDG-PET/CT: 증례 보고)

  • Cheon, Gi-Jeong;Choe, Jae-Gol;Chae, In-Jung;Lee, Dae-Hee;Song, Sang-Heon;Kim, Myo-Jong;Park, Jong-Hoon
    • The Journal of the Korean bone and joint tumor society
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    • v.18 no.1
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    • pp.45-49
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    • 2012
  • Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.

A Case of Monophasic Fibrous Synovial Sarcoma Confirmed Primary Pulmonary Origin by 18F-FDG PET/CT (PET/CT로 폐에서 기원한 것을 확인한 원발성 단상성 섬유성 활막육종 1예)

  • Lee, Eun A;Lee, Do Young;Kwag, Hyon Joo;Kim, Min Kyung;Oh, Tae Yun;Lim, Si Young;Lim, Seong Yong
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.6
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    • pp.673-677
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    • 2006
  • Most malignant mesenchymal tumors of the lung are metastases of a primary tumor from elsewhere in the body. A primary pulmonary synovial sarcoma is a very rare neoplasm that accounts for approximately 10% of soft tissue sarcomas and makes up only 0.5% of all primary lung malignancies. We report a case of a primary pulmonary synovial sarcoma in a 60-year old woman. In this case, a lung metastasis was excluded using 18F-FDG PET /CT imaging.

When We Consider Neurolymphomatosis in Patient with Lumbosacral Plexopathy with an Extreme Leg Pain? (통증을 동반한 신경총병증에서 언제 신경림프종증을 고려해야 하는가?)

  • Ahn, Jun Young;Seok, Hyun;Kim, Sang-Hyun;Kim, Hyun Jung;Cho, Yeon Hee;Oh, Back Min;Lee, Seung Yeol
    • Clinical Pain
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    • v.20 no.1
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    • pp.53-57
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    • 2021
  • We report a case of neurolymphomatosis of lumbosacral plexus. A 63-year-old man, who had no past history except for diabetes mellitus, complained of severe pain and weakness on left lower extremity. Idiopathic lumbosacral plexopathy was diagnosed by electromyography. There were no abnormal findings except for FDG-PET/CT and MRI. They showed high uptake and thickening lesion in sciatic nerve and sacral plexus. However, about 7 months later, mass like lesion in left thigh was detected by FDG-PET/CT and MRI. Also, multiple hypermetabolic lesions were found in brain. Through brain biopsy, diffuse large B-cell lymphoma was confirmed. When a patient with idiopathic lumbosacral plexopathy complains of severe pain, it is necessary to consider FDG-PET/CT and MRI to differentiate neurolymphomatosis, even in patients who have no past history of lymphoma before. Especially, if FDG-PET/CT and MRI show sciatic and/or lumbosacral plexus lesion, neurolymphomatosis of lumbosacral plexus should be considered.

Correlation Between Unidentified Bright Objects on Brain Magnetic Resonance Imaging (MRI) and Cerebral Glucose Metabolism in Patients with Neurofibromatosis Type 1

  • Sohn, Young Bae;An, Young Sil;Lee, Su Jin;Choi, Jin Wook;Jeong, Seon-Yong;Kim, Hyon-Ju;Ko, Jung Min
    • Journal of Genetic Medicine
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    • v.9 no.2
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    • pp.84-88
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    • 2012
  • Purpose: Neurofibromatosis type 1 (NF1), which is caused by mutations of the NF1 gene, is the most frequent single gene disorder to affect the nervous system. Unidentified bright objects (UBOs) are commonly observed on brain magnetic resonance imaging (MRI) in patients with NF1. However, their clinical and pathologic significance is not well understood. The purpose of this study was to investigate the correlation between UBOs and cerebral glucose metabolism measured by $^{18}F$-2-Fluoro-2-deoxy-D-glucose ($^{18}F$-FDG) positron emission tomography (PET) in Korean patients with NF1. Materials and Methods: Medical records of 75 patients (34 males and 41 females) with NF1 who underwent brain MRI and PET between 2005 and 2011 were evaluated retrospectively. Clinical data including demographics, neurological symptoms, and brain MRI and PET findings, were reviewed. Results: UBOs were detected in the brain MRI scans of 31 patients (41%). The region most frequently affected by UBOs was the basal ganglia. The most frequent brain PET finding was thalamic glucose hypometabolism (45/75, 60%). Of the 31 patients with UBOs, 26 had thalamic glucose hypometabolism on brain PET, but the other 5 had normal brain PET findings. Conversely, of the 45 patients with thalamic glucose hypometabolism on brain PET, 26 showed UBOs on their brain MRI scans, but 19 had normal findings on brain MRI scans. Conclusion: UBOs on brain MRI scans and thalamic glucose hypometabolism on PET appear to be 2 distinctive features of NF1 rather than correlated symptoms. Because the clinical significance of these abnormal imaging findings remains unclear, a longitudinal follow-up study of changes in clinical manifestations and imaging findings is necessary.

FDG-PET in Gynecologic Cancer (부인암에서 FDG-PET의 역할)

  • Ryu, Sang-Young
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.46-52
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    • 2002
  • Whole-body positron emission tomography (PET) imaging with 18-F deoxyglucose (FDG) is a molecular imaging modality that detects metabolic alteration in tumor cells. In various human cancers, FDG-PET shows a potential clinical benefit in screening, tumor characterization, staging, therapeutic follow-up and detecting recurrence. In gynecologic cancers, FDG-PET is also known to be effective in characterization of adnexal masses, detection of recurrence, and lymph node invasion. This review discusses the clinical feasibility and future clinical application of this imaging modality in patients with cervical cancer, ovarian cancer, and other gynecologic cancers.

The Prognostic Value of 18F-Fluorodeoxyglucose PET/CT in the Initial Assessment of Primary Tracheal Malignant Tumor: A Retrospective Study

  • Dan Shao;Qiang Gao;You Cheng;Dong-Yang Du;Si-Yun Wang;Shu-Xia Wang
    • Korean Journal of Radiology
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    • v.22 no.3
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    • pp.425-434
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    • 2021
  • Objective: To investigate the potential value of 18F-fluorodeoxyglucose (FDG) PET/CT in predicting the survival of patients with primary tracheal malignant tumors. Materials and Methods: An analysis of FDG PET/CT findings in 37 primary tracheal malignant tumor patients with a median follow-up period of 43.2 months (range, 10.8-143.2 months) was performed. Cox proportional hazards regression analyses were used to assess the associations between quantitative 18F-FDG PET/CT parameters, other clinic-pathological factors, and overall survival (OS). A risk prognosis model was established according to the independent prognostic factors identified on multivariate analysis. A survival curve determined by the Kaplan-Meier method was used to assess whether the prognosis prediction model could effectively stratify patients with different risks factors. Results: The median survival time of the 37 patients with tracheal tumors was 38.0 months, with a 95% confidence interval of 10.8 to 65.2 months. The 3-year, 5-year and 10-year survival rate were 54.1%, 43.2%, and 16.2%, respectively. The metabolic tumor volume (MTV), total lesion glycolysis (TLG), maximum standardized uptake value, age, pathological type, extension categories, and lymph node stage were included in multivariate analyses. Multivariate analysis showed MTV (p = 0.011), TLG (p = 0.020), pathological type (p = 0.037), and extension categories (p = 0.038) were independent prognostic factors for OS. Additionally, assessment of the survival curve using the Kaplan-Meier method showed that our prognosis prediction model can effectively stratify patients with different risks factors (p < 0.001). Conclusion: This study shows that 18F-FDG PET/CT can predict the survival of patients with primary tracheal malignant tumors. Patients with an MTV > 5.19, a TLG > 16.94 on PET/CT scans, squamous cell carcinoma, and non-E1 were more likely to have a reduced OS.

Value of Bone Scan in Addition to F-18 FDG PET/CT and Characteristics of Discordant lesions between F-18 FDG PET/CT and Bone Scan in the Spinal Bony Metastasis (척추골전이에 있어 F-18 FDG PET/CT에 대한 골스캔의 추가적 역할 및 F-18 FDG PET/CT와 골스캔간에 불일치 병소에 대한 연구)

  • Jun, Sung-Min;Nam, Hyun-Yeol;Kim, In-Ju;Kim, Yong-Ki;Kim, Ju-Sung
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.3
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    • pp.218-228
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    • 2008
  • Purpose: Our purpose was to evaluate spinal bony metastasis which could be missed on an F-18 FDG PET/CT (FDG PET/CT) alone, and to characterize discordant metastatic lesions between FDG PET/CT and bone scan. Material and Methods: FDG PET/CT and bone scans of 43 patients with spinal bony metastasis were analyzed retrospectively. A McNemar test was performed comparing the FDG PET/CT alone to the FDG PET/CT plus bone scan in the spinal bony metastases. A one-way chi-square test was performed to characterize the metastases that were missed on the FDG PET/CT alone. To evaluate discordant lesions between FDG PET/CT and bone scan, we performed logistic regression analyses. The independent variables were sites (cervical, thoracic, and lumbar), size (large and small), and maximum SUVs, and the dependant variable was bone scan uptake (positive and negative MDP uptake). Results: A significant difference was found between the FDG PET/CT alone and the FDG PET/CT combined with the bone scan (p < 0.01). Using the FDG PET/CT only, diffuse osteoblastic metastasis was missed with a significantly higher frequency (p = 0.04). In the univariate analysis, cervical vertebra and small size were related to negative MDP uptake, and thoracic vertebra and large size were related to positive MDP uptake. However, in the multivariate analysis, only the large size was related to positive MDP uptake. Conclusion: A bone scan in addition to the FDG PET/CT increased the ability to evaluate spinal bony metastases, especially for diffuse osteoblastic metastasis. Large metastasis was related to positive bone scan uptake in spinal bony metastasis.

Current Status and Future Perspective of PET (PET 이용 현황 및 전망)

  • Lee, Myung-Chul
    • The Korean Journal of Nuclear Medicine
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    • v.36 no.1
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    • pp.1-7
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    • 2002
  • Positron Emission Tomography (PET) is a nuclear medicine imaging modality that consists of systemic administration to a subject of a radiopharmaceutical labeled with a positron-emitting radionuclide. Following administration, its distribution in the organ or structure under study can be assessed as a function of time and space by (1) defecting the annihilation radiation resulting from the interaction of the positrons with matter, and (2) reconstructing the distribution of the radioactivity from a series of that used in computed tomography (CT). The nuclides most generally exhibit chemical properties that render them particularly desirable in physiological studies. The radionuclides most widely used in PET are F-18, C-11, O-15 and N-13. Regarding to the number of the current PET Centers worldwide (based on ICP data), more than 300 PET Centers were in operation in 2000. The use of PET technology grew rapidly compared to that in 1992 and 1996, particularly in the USA, which demonstrates a three-fold rise in PET installations. In 2001, 194 PET Centers were operating in the USA. In 1994, two clinical and research-oriented PET Centers at Seoul National University Hospital and Samsung Medical Center, was established as the first dedicated PET and Cyclotron machines in Korea, followed by two more PET facilities at the Korea Cancer Center Hospital, Ajou Medical Center, Yonsei University Medical Center, National Cancer Center and established their PET Center. Catholic Medical School and Pusan National University Hospital have finalized a plan to install PET machine in 2002, which results in total of nine PET Centers in Korea. Considering annual trends of PET application in four major PET centers in Korea in Asan Medical Center recent six years (from 1995 to 2000), a total of 11,564 patients have been studied every year and the number of PET studies has shown steep growth year upon year. We had 1,020 PET patients in 1995. This number increased to 1,196, 1,756, 2,379, 3,015 and 4,414 in 1996,1997,1998,1999 and 2000, respectively. The application in cardiac disorders is minimal, and among various neuropsychiatric diseases, patients with epilepsy or dementia can benefit from PET studios. Recently, we investigated brain mapping and neuroreceptor works. PET is not a key application for evaluation of the cardiac patients in Korea because of the relatively low incidence of cardiac disease and less costly procedures such as SPECT can now be performed. The changes in the application of PET studios indicate that, initially, brain PET occupied almost 60% in 1995, followed by a gradual decrease in brain application. However, overall PET use in the diagnosis and management of patients with cancer was up to 63% in 2000. The current medicare coverage policy in the USA is very important because reimbursement policy is critical for the promotion of PET. In May 1995, the Health Care Financing Administration (HCFA) began covering the PET perfusion study using Rubidium-82, evaluation of a solitary pulmonary nodule and pathologically proven non-small cell lung cancer. As of July 1999, Medicare's coverage policy expanded to include additional indications: evaluation of recurrent colorectal cancer with a rising CEA level, staging of lymphoma and detection of recurrent or metastatic melanoma. In December of 2001, National Coverage decided to expand Medicare reimbursement for broad use in 6 cancers: lung, colorecctal, lymphoma, melanoma, head and neck, and esophageal cancers; for determining revascularization in heart diseases; and for identifying epilepsy patients. In addition, PET coverage is expected to further expand to diseases affecting women, such as breast, ovarian, uterine and vaginal cancers as well as diseases like prostate cancer and Alzheimer's disease.

Non-specific Inflammatory Disease Showed Abnormal FDG Uptake in Lower Extremities ($^{18}F-FDG$ PET/CT 에서 하지골 골수에 다발성 이상섭취를 보인 비특이성 염증성질환)

  • Chun, Kyung-Ah;Kong, Eun-Jung;Cho, Ihn-Ho;Hong, Young-Hoon;Lee, Choong-Ki
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.1
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    • pp.79-80
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    • 2008
  • Including malignancy, various disease can show abnormal uptake in bone marrow. We report a case of non-specific inflammatory FDG uptake in bone marrow mimicking malignancy. A 35-year old woman with fever of unknown origin (FUO) underwent $^{18}F$-FDG PET/CT to find out fever $^{18}F$-FDG and unknown malignancy. $^{18}F$-FDG was injected and imaged 1hr after injection with Discovery ST (GE, USA), $^{18}F$-FDG PET/CT whole body image showed abnormal uptake in lower extremities (Fig. 1). MRI and biopsy was also done in the sites of abnormal uptake. PET and MRI suspect malignancy (Fig. 2, 3), but biopsy result was non-specific inflammatory process (Fig. 4). The patient was improved her clinical condition after antibiotics therapy.

Synthetic approaches toward [18F]Fluoromisonidazole as a hypoxia imaging maker

  • Kwon, Young-Do;Lim, Seok Tae;Jeong, Hwan-Jeong;Sohn, Myung-Hee;Kim, Hee-Kwon
    • Journal of Radiopharmaceuticals and Molecular Probes
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    • v.1 no.1
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    • pp.9-14
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    • 2015
  • Hypoxia has been shown in many tumors because of a reduced oxygen condition. A useful approach to detect hypoxia is to use molecular imaging. Positron emission tomography (PET), one of the biomedical molecular imaging tools, is the most common non-invasive technique for providing information about physiological and biological events such as diseases. In order to use the PET technique for healthcare, promising molecular probes such as PET tracers required. [$^{18}F$]Fluoromisonidazole ([$^{18}F$]FMISO) is the most widely used in PET tracers for hypoxia. In this review, major developments of the synthetic method of [$^{18}F$]FMISO are discussed.