• Journal of the Korean Orthopaedic Association
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• v.56 no.5
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• pp.398-403
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• 2021

Purpose: A biopsy is needed to diagnose soft tissue tumors. However, it is extremely difficult to pinpoint the site of a tumor due to the heterogeneity of sarcomas. Thus, even when an open biopsy is conducted, it is difficult to diagnose a soft tissue tumor. In such cases, an ultrasound (US)-guided biopsy is used to improve the diagnostic accuracy. This study evaluated the accuracy of US-guided biopsy for a diagnosis of soft tissue tumors found initially in a magnetic resonance (MR) perfusion and assessed the availability of positron emission tomography-computed tomography (PET-CT) for a diagnosis of soft tissue tumors. Materials and Methods: From January 2014 to December 2018, the US-guided biopsy was performed on 152 patients with a suspected soft tissue tumor found in an MR perfusion and 86 cases were definitively diagnosed with a soft tissue tumor. The accuracy of the US-guided biopsy was assessed retrospectively. Among the 86 cases, only MR perfusion was used before the biopsy in 50 cases, while both MR perfusion and PET-CT was conducted on 36 cases. The accuracy was analyzed to determine if the PET-CT could improve the precision of a biopsy. Results: From 86 cases, 34 out of 50 cases, in which only MR perfusion had been conducted, matched the result of the definitive diagnosis and the US-guided biopsy. 32 out of 36 cases, in which both PET-CT and MR perfusion were conducted, matched the definitive diagnosis and the US-guided biopsy. These results show significant differences in the accuracy of US-guided biopsy. In the case of soft tissue sarcomas, 6 out of 12 cases, in which only MR perfusion had been conducted, matched the result of the definitive diagnosis and the US-guided biopsy. 17 out of 18 cases, in which both PET-CT and MR perfusion were conducted, matched the definitive diagnosis. Moreover US-guided biopsy also showed significant differences in the accuracy of US-guided biopsy. Conclusion: In diagnosing soft tissue tumors, a US-guided biopsy is a well-known tool for its high accuracy. However, the heterogeneity of sarcoma makes it difficult to locate the exact site for a biopsy using only MR perfusion. Thus, the use of PET-CT will meaningfully improve the accuracy of a diagnosis by precisely targeting the site for the US-guided biopsy.

• Journal of Gastric Cancer
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• v.18 no.3
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• pp.218-229
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• 2018

Purpose: This study investigated whether the metabolic avidity of primary tumors and/or metastatic lymph nodes (LNs) measured by $^{18}F$-fluorodeoxyglucose ($^{18}F-FDG$) positron emission tomography/computed tomography (PET/CT) was related to survival after surgery in patients with advanced gastric cancer (AGC). Materials and Methods: One hundred sixty-eight patients with AGC who underwent preoperative $^{18}F-FDG$ PET/CT and curative resection were included. The $^{18}F-FDG$ avidity of the primary gastric tumor and LNs was determined quantitatively and qualitatively. The diagnostic performance of $^{18}F-FDG$ PET/CT was calculated, and the prognostic significance of $^{18}F-FDG$ avidity for recurrence-free survival (RFS) and overall survival (OS) was assessed. Results: In all, 51 (30.4%) patients experienced recurrence, and 32 (19.0%) died during follow-up (median follow-up duration, 35 months; range, 3-81 months); 119 (70.8%) and 33 (19.6%) patients showed $^{18}F-FDG$-avid primary tumors and LNs, respectively. $^{18}F-FDG$ PET/CT showed high sensitivity (73.8%) for the detection of advanced pathologic T ($pT{\geq}3$) stage and high specificity (92.2%) for the detection of advanced pN (${\geq}2$) stage. $^{18}F-FDG$ avidity of LNs was significantly associated with RFS (P=0.012), whereas that of primary tumors did not show significance (P=0.532). Univariate and multivariate analyses revealed that $^{18}F-FDG$ avidity of LNs was an independent prognostic factor for RFS (hazard ratio=2.068; P=0.029). Conclusions: $^{18}F-FDG$ avidity of LNs is an independent prognostic factor for predicting RFS. Preoperative $^{18}F-FDG$ PET/CT can be used to determine the risk and prognosis of patients with AGC after curative resection.

• Journal of Gynecologic Oncology
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• v.29 no.6
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• pp.98.1-98.13
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• 2018

Objective: We describe a systematic review and meta-analysis of the performance of ${18}F$-fluorodeoxyglucose ($^{18}F-FDG$) positron emission tomography/computed tomography (PET/CT) for detecting metastasis in ovarian cancer. Methods: MEDLINE and Embase were searched for diagnostic accuracy studies that used $^{18}F-FDG$ PET or PET/CT for pre-treatment staging, using surgical findings as the reference standard. Sensitivities and specificities were pooled and plotted in a hierarchic summary receiver operating characteristic plot. Potential causes of heterogeneity were explored through sensitivity analyses. Results: Eight studies with 594 patients were included. The overall pooled sensitivity and specificity for metastasis were 0.72 (95% confidence interval [CI]=0.61-0.81) and 0.93 (95% CI=0.85-0.97), respectively. There was considerable heterogeneity in sensitivity ($I^2=97.57%$) and specificity ($I^2=96.74%$). In sensitivity analyses, studies that used laparotomy as the reference standard showed significantly higher sensitivity and specificity (0.77; 95% CI=0.67-0.87 and 0.96; 95% CI=0.92-0.99, respectively) than those including diagnostic laparoscopy (0.62; 95% CI=0.46-0.77 and 0.84; 95% CI=0.69-0.99, respectively). Higher specificity was shown in studies that confirmed surgical findings by pathologic evaluation (0.95; 95% CI=0.90-0.99) than in a study without pathologic confirmation (0.69; 95% CI=0.24-1.00). Studies with a lower prevalence of the FDG-avid subtype showed higher specificity (0.97; 95% CI=0.94-1.00) than those with a greater prevalence (0.89; 95% CI=0.80-0.97). Conclusion: Pre-treatment $^{18}F-FDG$ PET/CT shows moderate sensitivity and high specificity for detecting metastasis in ovarian cancer. With its low false-positive rate, it can help select surgical approaches or alternative treatment options.

• Korean Journal of Radiology
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• v.21 no.7
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• pp.829-837
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• 2020

Objective: The aim of this study was to investigate the prognostic value of the maximum standardized uptake value (SUV_max) measured while restaging with F-18 fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography/computed tomography (PET/CT) to predict the 3-year post-recurrence survival (PRS) in patients with recurrent gastric cancer after curative surgical resection. Materials and Methods: In total, 47 patients with recurrent gastric cancer after curative resection who underwent restaging with ¹⁸F-FDG PET/CT were included. For the semiquantitative analysis, SUV_max was measured over the visually discernable ¹⁸F-FDG-avid recurrent lesions. Cox proportional-hazards regression models were used to predict the 3-year PRS. Differences in 3-year PRS were assessed with the Kaplan-Meier analysis. Results: Thirty-nine of the 47 patients (83%) expired within 3 years after recurrence in the median follow-up period of 30.3 months. In the multivariate analysis, SUV_max (p = 0.012), weight loss (p = 0.025), and neutrophil count (p = 0.006) were significant prognostic factors for 3-year PRS. The Kaplan-Meier curves demonstrated significantly poor 3-year PRS in patients with SUV_max > 5.1 than in those with SUV_max ≤ 5.1 (3-year PRS rate, 3.5% vs. 38.9%, p < 0.001). Conclusion: High SUV_max on restaging with ¹⁸F-FDG PET/CT is a poor prognostic factor for 3-year PRS. It may strengthen the role of ¹⁸F-FDG PET/CT in further stratifying the prognosis of recurrent gastric cancer.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.7 no.2
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• pp.99-103
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• 2021

In this study, the initial in vivo pharmacokinetic changes according to the routes of drug administration were investigated using bioimaging techniques. The purpose of this study was to quantify the degree of distribution of each major organ in normal mice over time by acquiring Positron Emission Tomography/Computed Tomography images while administering routes F-18 fluorodeoxyglucose such as intravenous, intraperitoneal and per oral, a representative diagnostic radiopharmaceutical. Dynamic Positron Emission Tomography images were acquired for 90 minutes after drug administration. Radioactivity uptake was calculated for major organs using the PMOD program. In the case of intravenous administration, it was confirmed that it spread quickly and evenly to major organs. Compared to intravenous administration, intraperitoneal administration was about three times more absorbed and distributed in the liver and intestine, and it was showed that the amount excreted through the bladder was more than twice. In the case of oral administration, most stayed in the stomach, and it was showed that it spread slowly throughout the body. In comparison with intravenous administration, it was presented that the distribution of kidneys was more than 9 times and the distribution of bladder was 66% lower. Since there is a difference in the initial in vivo distribution and excretion of each administration method, we confirmed that the determination of the administration route is important for in vivo imaging evaluation of new drug candidates.

• Journal of the Korean Society of Radiology
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• v.16 no.5
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• pp.499-504
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• 2022

Positron emission tomography (PET) uses a very small scintillator to achieve exellent spatial resolution. Therefore, in this study, a PET system using a scintillator to 0.8 mm size was designed and the performance was evaluated. Anihilation radiation was generated from the center of the field of view (FOV) to the outskirts at intervals of 10 mm, and counted simultaneously. The image was reconstructed using the coincidence data, and the spatial resolution was calculated by acquiring the full width at half maximum through the profile. The spatial resolution at the center of the FOV was 1.02 mm, showing a very good result, and the spatial resolution decreased as it was located at the outer edge. To evaluate the phantom image, the Derenzo phantom was constructed to acquire the image, and the degree of classification between radiation sources was evaluated through profile analysis. The result showed that the distance between the radiation sources was larger than the spatial resolution of the radiation sources at each location, and it was confirmed that the radiation sources were distinguished through this. When the PET system designed in this study is applied to PET for small animals, it is considered that excellent performance can be secured through the characteristic of very good spatial resolution.

• 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.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.5 no.1
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• pp.36-47
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• 2019

Hypoxia-inducible factor-1 ($HIF-1{\alpha}$) is a transcription factor activated in response to low oxygen level, and is highly expressed in many solid tumors. Moreover, $HIF-1{\alpha}$ is a representative biomarker of hypoxia and also helps to maintain cell homeostasis under hypoxic condition. Most solid tumors show hypoxia, which induces poor prognosis and resistance to conventional cancer therapies. Thus, early diagnosis of hypoxia with positron emission tomography (PET) radiotracer would be highly beneficial for management of malignant solid tumors with effective cancer therapy. YC-1 is a most promising candidate among several $HIF-1{\alpha}$ inhibitors. As an effort to develop a hypoxia imaging tool as a PET radiotracer, we designed and synthesized [$^{18}F$]DFYC based on potent derivative of YC-1 and performed preliminary in vitro cell uptake study. [$^{18}F$]DFYC showed a significant accumulation in SKBR-3 cells among other cancer cells, proving as a good lead to develop a hypoxic solid tumor such as breast cancer.

• Nuclear Engineering and Technology
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• v.56 no.5
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• pp.1733-1737
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• 2024

In order to specify the location of the scintillation pixel that interacted with gamma rays in the positron emission tomography (PET) detector, conventionally, after acquiring a flood image, the location of interaction between the scintillation pixel and gamma ray could be specified through a pixel-segmentation process. In this study, the experimentally acquired signal was specified as the location of the scintillation pixel directly, without any conversion process, through the simulation data and the deep learning algorithm. To evaluate the accuracy of the specification of the scintillation pixel location through deep learning, a comparative analysis with experimental data through pixel segmentation was performed. In the same way as in the experiment, a detector was configured on the simulation, a model was built using the acquired data through deep learning, and the location was specified by applying the experimental data to the built model. Accuracy was calculated through comparative analysis between the specified location and the location obtained through the segmentation process. As a result, it showed excellent accuracy of about 85 %. When this method is applied to a PET detector, the position of the scintillation pixel of the detector can be specified simply and conveniently, without additional work.

• Journal of Radiation Industry
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• v.9 no.3
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• pp.143-151
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• 2015

A PET-MR system is particularly useful in diagnosing brain diseases. We have developed a prototype positron emission tomography (PET) system which can be inserted into the bore of a whole-body magnetic resonance imaging (MRI) system that enables us to obtain PET and MRI images simultaneously with a reduced cost. Silicon photomultipliers (SiPM) are appropriated as a PET detector at PET/MR system because detectors have a high gain and are insensitive to magnetic fields. Despite of its improved performance compared to that of PMT-based detectors, there is a problem of the photo-peak channel shift which is due to the increase of the temperature inside the ring detector. This problem will occur decreasing sensitivity of the PET and image distortion. In this paper, I quantitative analyze parameters of the KAIST SiPM depending on temperature by experiments. And I designed cooling methods in consideration of the degradation of sensors for correction of the temperature in the PET gantry. According to this research, we expect that distortive images and degradation of the sensitivity will not be occurred with using the above idea to reduce heat even if the PET system operates for a long time.