• Korean Journal of Radiology
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• v.23 no.1
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• pp.112-123
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• 2022

Objective: To investigate the relationship between ¹⁸F-FDG PET/CT semi-quantitative parameters and the International Association for the Study of Lung Cancer, American Thoracic Society/European Respiratory Society (IASLC/ATS/ERS) histopathologic classification, including histological subtypes, proliferation activity, and somatic mutations. Materials and Methods: This retrospective study included 419 patients (150 males, 269 females; median age, 59.0 years; age range, 23.0-84.0 years) who had undergone surgical removal of stage IA-IIIA lung adenocarcinoma and had preoperative PET/CT data of lung tumors. The maximum standardized uptake values (SUVmax), background-subtracted volume (BSV), and background-subtracted lesion activity (BSL) derived from PET/CT were measured. The IASLC/ATS/ERS subtypes, Ki67 score, and epidermal growth factor/anaplastic lymphoma kinase (EGFR/ALK) mutation status were evaluated. The PET/CT semi-quantitative parameters were compared between the tumor subtypes using the Mann-Whitney U test or the Kruskal-Wallis test. The optimum cutoff values of the PET/CT semi-quantitative parameters for distinguishing the IASLC/ATS/ERS subtypes were calculated using receiver operating characteristic curve analysis. The correlation between the PET/CT semi-quantitative parameters and pathological parameters was analyzed using Spearman's correlation. Statistical significance was set at p < 0.05. Results: SUVmax, BSV, and BSL values were significantly higher in invasive adenocarcinoma (IA) than in minimally IA (MIA), and the values were higher in MIA than in adenocarcinoma in situ (AIS) (all p < 0.05). Remarkably, an SUVmax of 0.90 and a BSL of 3.62 were shown to be the optimal cutoff values for differentiating MIA from AIS, manifesting as pure ground-glass nodules with 100% sensitivity and specificity. Metabolic-volumetric parameters (BSV and BSL) were better potential independent factors than metabolic parameters (SUVmax) in differentiating growth patterns. SUVmax and BSL, rather than BSV, were strongly or moderately correlated with Ki67 in most subtypes, except for the micropapillary and solid predominant groups. PET/CT parameters were not correlated with EGFR/ALK mutation status. Conclusion: As noninvasive surrogates, preoperative PET/CT semi-quantitative parameters could imply IASLC/ATS/ERS subtypes and Ki67 index and thus may contribute to improved management of precise surgery and postoperative adjuvant therapy.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.116-120
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• 2008

Prostate cancer is the second leading cause of cancer death of men in western countries and the death related to this disease in Korea is also getting increased. Although anatomic imaging tools such as transrectal US or MRI have been playing a great role in detection of primary prostate lesion, the evaluation of regional lymph node or distant organ metastasis using these modalities is not successful. $^{18}F-FDG-PET$ scan is emerging diagnostic tool for various malignancies. Considering the usual characteristics of prostate cancer such as slow growing and osteoblastic metastasis, the application of FDG PET scan to this disease might be limited. However, in advanced prostate cancer refractory to chemotherapy, FDG PET scan show strong FDG uptake and SUV changes in serial PET scan can be a good indicator of treatment response. Although FDG PET can be useful only in limited cases of prostate cancer, its indication can be widened in future owing to rapid technical improvement and accumulated experiences in this field.

• 대한핵의학회:학술대회논문집
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• 2002.05a
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• pp.9-13
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• 2002

Clinical application of positron emission tomography (PET) is rapidly increasing for the detection and staging of cancer at whole-body studios performed with 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG). Although many cancers can be detected by FDG-PET, there has been limited clinical experience with FDG-PET for the defection of gynecological cancers including malignancies in uterus and ovary. FDG-PET can show foci of metastatic disease that may not be apparent at conventional anatomic imaging and can and in the characterization of indeterminate soft-tissue masses. Most gynecological cancers need to surgical management. FDG-PET can improve the selection of patients for surgical treatment and thereby reduce the morbidity and mortality associated with inappropriate surgery. FDG-PET is also useful for the early detection of recurrence and the monitoring of therapeutic effect. In this review, I discuss the clinical feasibility and limitations of this imaging modality in patients with gynecological cancers.

• Progress in Medical Physics
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• v.24 no.1
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• pp.76-83
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• 2013

Previous studies about effect of respiratory motion on diagnostic imaging and radiation therapy have been performed by monitoring external motions but these can not reflect internal organ motion well. The aim of this study was to develope the artificial pulmonary nodule able to perform non-invasive implantation to dogs in the thorax and to evaluate applicability of the model to respiratory motion studies on PET image acquisition and radiation delivery by phantom studies. Artificial pulmonary nodule was developed on the basis of 8 Fr disposable gastric feeding tube. Four anesthetized dogs underwent implantation of the models via trachea and implanted locations of the models were confirmed by fluoroscopic images. Artificial pulmonary nodule models for PET injected $^{18}F$-FDG and mounted on the respiratory motion phantom. PET images of those acquired under static, 10-rpm- and 15-rpm-longitudinal round motion status. Artificial pulmonary nodule models for radiation delivery inserted glass dosemeter and mounted on the respiratory motion phantom. Radiation delivery was performed at 1 Gy under static, 10-rpm- and 15-rpm-longitudinal round motion status. Fluoroscpic images showed that all models implanted in the proximal caudal bronchiole and location of models changed as respiratory cycle. Artificial pulmonary nodule model showed motion artifact as respiratory motion on PET images. SNR of respiratory gated images was 7.21. which was decreased when compared with that of reference images 10.15. However, counts of respiratory images on profiles showed similar pattern with those of reference images when compared with those of static images, and it is assured that reconstruction of images using by respiratory gating improved image quality. Delivery dose to glass dosemeter inserted in the models were same under static and 10-rpm-longitudinal motion status with 0.91 Gy, but dose delivered under 15-rpm-longitudinal motion status was decreased with 0.90 Gy. Mild decrease of delivered radiation dose confirmed by electrometer. The model implanted in the proximal caudal bronchiole with high feasibility and reflected pulmonary internal motion on fluoroscopic images. Motion artifact could show on PET images and respiratory motion resulted in mild blurring during radiation delivery. So, the artificial pulmonary nodule model will be useful tools for study about evaluation of motion on diagnostic imaging and radiation therapy using laboratory animals.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.sup1
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• pp.130-133
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• 2008

Adrenal tumors are increasingly detected by widespread use of anatomical imaging such as a, MRI, etc. For these adrenal tumors, differentiation between malignancy and benignancy is very important. In diagnostic assessment of adrenal tumor, $^{18}F-FDG$ PET and PET-CT have been reported to have high diagnostic performance, especially, very excellent performance in evaluation of adrenal metastasis in the oncologic patient. In cases of adrenal incidentalomas, $^{18}F-FDG$ PET or PET-CT is helpful if a or chemical-shift MRI is inconclusive. $^{18}F-FDG$ PET and PET-CT may be applied to the patients with MIBG-negative pheochromocytomas. In summary, $^{18}F-FDG$ PET and PET-CT are expected to be effective diagnostic tools in the management of adrenal tumor.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.2
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• pp.150-153
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• 2009

Xanthogranulomatous pyelonephritis is an uncommon chronic renal infection, which is usually found on middle-aged women and is rare in infant. Sometimes it forms focal mass like lesion of kidney with pathologically characteristic lipid-laden macrophage. A 1-month female infant was admitted for fever and moaning sound. On work-up of urinary tract infection, abdomen ultrasonography and computed tomography revealed a large mass on the upper portion of right kidney and PET/CT showed homogeneously increased $^{18}F$-FDG uptake. The radical nephrectomy of right kidney was performed and histology revealed a focal xanthogranulomatous pyelonephritis. To our knowledge, this is the first report presenting the finding of $^{18}F$-FDG PET/CT in the childhood xanthogranulomatous pyelonephritis.

• Nuclear Medicine and Molecular Imaging
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• v.42 no.5
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• pp.401-409
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• 2008

Purpose: Recently multi-modal imaging system has become widely adopted in molecular imaging. We tried to fabricate animal-specific positioning molds for PET/MR fusion imaging using easily available molding clay and rapid foam. The animal-specific positioning molds provide immobilization and reproducible positioning of small animal. Herein, we have compared fiber-based molding clay with rapid foam in fabricating the molds of experimental animal. Materials and Methods: The round bottomed-acrylic frame, which fitted into microPET gantry, was prepared at first. The experimental mice was anesthetized and placed on the mold for positioning. Rapid foam and fiber-based clay were used to fabricate the mold. In case of both rapid foam and the clay, the experimental animal needs to be pushed down smoothly into the mold for positioning. However, after the mouse was removed, the fabricated clay needed to be dried completely at $60^{\circ}C$ in oven overnight for hardening. Four sealed pipet tips containing $[^{18}F]FDG$ solution were used as fiduciary markers. After injection of $[^{18}F]FDG$ via tail vein, microPET scanning was performed. Successively, MRI scanning was followed in the same animal. Results: Animal-specific positioning molds were fabricated using rapid foam and fiber-based molding clay for multimodality imaging. Functional and anatomical images were obtained with microPET and MRI, respectively. The fused PET/MR images were obtained using freely available AMIDE program. Conclusion: Animal-specific molds were successfully prepared using easily available rapid foam, molding clay and disposable pipet tips. Thanks to animal-specific molds, fusion images of PET and MR were co-registered with negligible misalignment.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.2 no.2
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• pp.73-83
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• 2016

Imaging hypoxia using positron emission tomography (PET) is of great importance for cancer therapy. [$^{18}F$] Fluoromisonidazole (FMISO) was the first PET agent used for imaging tumor hypoxia. Various radiolabeled nitroimidazole derivatives such as [$^{18}F$]fluoroerythronitroimidazole (FETNIM), [$^{18}F$]1-${\alpha}$-D-(2-deoxy-2-fluoroarabinofuranosyl)-2-nitroimidazole(FAZA), 2-(2-nitroimidazol-1-yl)-N-(3,3,3-[18F]-trifluoropropyl)acetamide ([$^{18}F$]EF-3), [$^{18}F$]2-(2-nitro-1H-imidazol-1-yl)-N-(2,2,3,3,3-pentafluoropropyl) acetamide (EF-5), 3-[$^{18}F$]fluoro-2-(4-((2-nitro-1H-imidazol-1-yl)methyl)-1H-1,2,3,-triazol-1-yl)-propan-1-ol ([$^{18}F$]HX-4), and [$^{18}F$]fluoroetanidazole (FETA) were developed successively. However, these imaging agents still produce PET images with limited resolution; the lower blood flow in hypoxic tumors compared to normoxic tumors results in low uptake of the agents in hypoxic tumors. Thus, the development of better imaging agents is necessary.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.1 no.1
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• pp.1-8
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• 2015

It is essential use of long term half life radioisotopes for positron emission tomography (PET) imaging study of biopharmaceuticals because most of biopharmaceuticals have long biological half-life. Some representative isotopes are $^{124}I$, $^{64}Cu$, $^{89}Zr$ and so on. These PET radioisotopes and their radiopharmaceuticals have recently received growing interest because of long half life and good imaging properties. Furthermore, $^{64}Cu$ and $^{89}Zr$ can be used in a number of radiopharmaceuticals due to its ease of conjugation to peptides and antibodies using the proper chelator. In recent years, since $^{124}I$ was first developed in 2005, we have been studied to develop an efficient method and procedure for producing these radioisotopes, and we have made considerable progress in production of long term half life radioisotopes. This review introduces the general production system, purification procedure, and several advances on targeting method for $^{124}I$ and $^{64}Cu$ in KIRAMS.

• Nuclear Medicine and Molecular Imaging
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• v.43 no.3
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• pp.203-206
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• 2009

Nuclear cardiac imaging has been widely used to assess viable myocardium in patients with ischemic heart disease, The assessment of viable myocardium is important in selecting patients who will be benefit from revascularization. Although revascularization is indicated in patients with sufficient myocardium, patients with scar tissue should be treated medically. Nuclear imaging methods including myocardial perfusion SPECT and FDG PET have been shown to be effective modalities for identifying viable myocardium.