• Nuclear Engineering and Technology
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• v.51 no.6
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• pp.1610-1615
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• 2019

Positron emission tomography (PET)/magnetic resonance (MR) scanning has the advantage of less additional exposure to radiation than does PET/computed tomography (CT). In particular, MR based attenuation correction (MR AC) can greatly affect the image quality of PET and is frequently obtained using various MR sequences. Thus, the purpose of the current study was to quantitatively compare the image quality between MR non-AC (MR NAC) and MR AC in PET images with three MR sequences. Percent image uniformity (PIU), percent contrast recovery (PCR), and percent background variability (PBV) were estimated to evaluate the quality of PET images with MR AC. Based on the results of PIU, 15.2% increase in the average quality was observed for PET images with MR AC than for PET images with MR NAC. In addition, 28.6% and 71.1% improvement in the average results of PCR and PBV respectively, was observed for PET images with MR AC compared with that with MR NAC. Moreover, no significant difference was observed among the average values using three MR sequences. In conclusion, the current study demonstrated that PET with MR AC improved the image quality and can be help diagnosis in all MR sequence cases.

• Progress in Medical Physics
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• v.32 no.2
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• pp.25-39
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• 2021

Brachytherapy, along with external beam radiation therapy (EBRT), is an essential and effective radiation treatment process. In brachytherapy, in contrast to EBRT, the radiation source is radioisotopes. Because these isotopes can be positioned inside or near the tumor, it is possible to protect other organs around the tumor while delivering an extremely high-dose of treatment to the tumor. Brachytherapy has a long history of more than 100 years. In the early 1900s, the radioisotopes used for brachytherapy were only radium or radon isotopes extracted from nature. Over time, however, various radioisotopes have been artificially produced. As radioisotopes have high radioactivity and miniature size, the application of brachytherapy has expanded to high-dose-rate brachytherapy. Recently, advanced treatment techniques used in EBRT, such as image guidance and intensity modulation techniques, have been applied to brachytherapy. Three-dimensional images, such as ultrasound, computed tomography, magnetic resonance imaging, and positron emission tomography are used for accurate delineation of treatment targets and normal organs. Intensity-modulated brachytherapy is anticipated to be performed in the near future, and it is anticipated that the treatment outcomes of applicable cancers will be greatly improved by this treatment's excellent dose delivery characteristics.

• Journal of Yeungnam Medical Science
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• v.39 no.2
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• pp.153-160
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• 2022

Multicentric Castleman disease (MCD) is an uncommon systemic lymphoproliferative disorder that may cause multiple organ damage. Castleman disease-associated diffuse parenchymal lung disease (DPLD) has not been well studied. A 32-year-old man was referred to our hospital for progressive generalized weakness, light-headedness, and dyspnea on exertion for more than one year. Laboratory evaluations showed profound anemia, an elevated erythrocyte sedimentation rate, and an increased C-reactive protein level with polyclonal hypergammaglobulinemia. Chest radiography, computed tomography (CT), and positron emission tomography-CT scan demonstrated diffuse lung infiltration with multiple cystic lesions and multiple lymphadenopathy. In addition to these clinical laboratory findings, bone marrow, lung, and lymph node biopsies confirmed the diagnosis of idiopathic MCD (iMCD). Siltuximab, an interleukin-6 inhibitor, and glucocorticoid therapy were initiated. The patient has been tolerating the treatment well and had no disease progression or any complications in 4 years. Herein, we report this case of human herpesvirus-8-negative iMCD-associated DPLD accompanied by multiple cystic lesions, multiple lymphadenopathy, and polyclonal hypergammaglobulinemia with elevated immunoglobulin G (IgG) and IgG4 levels. We recommend a close evaluation of MCD in cases of DPLD with hypergammaglobulinemia.

• Journal of radiological science and technology
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• v.45 no.5
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• pp.423-431
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• 2022

The purpose of this study is to present objective information in applying 3D printing technology for PET/CT (Positron Emission Tomography/Computed Tomography) performance evaluation and use it as a basic research that can be applied to various purposes in the future. Phantoms were manufactured with step wedge of ABS(Acrylonitrile Butadiene Styrene) and ACR(Acrylic acid) material. The counts for each ROI(Region of Interest) were analyzed through image acquisition in PET/CT. And the variation rate of counts and CNR(Contrast Noise Ratio) was evaluated. In the counts analysis, the effect of thickness occurred. In addition, in the variation rate analysis, the thickness setting of steps wedge 4 to 5 levels should be considered first. These results minimize quantitative and qualitative changes in the phantom manufactured based on 3D printing, and enable more stable PET/CT performance evaluation. Based on 3D printing in PET/CT, various phantoms are expected to be produced in the future. If the characteristics of each material are considered and applied through the basic research such as this research, the result of the phantom manufactured through 3D printing can be more meaningful and will be used in a wide range.

• Journal of Digestive Cancer Research
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• v.11 no.1
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• pp.49-54
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• 2023

Colorectal cancers often invade adjacent organs; however, direct duodenal invasion is rare. Adenocarcinoma is the most common type of colorectal cancer, but an undifferentiated carcinoma type is unusual. Herein, we present a case of undifferentiated carcinoma of the colon that directly invaded the duodenum and metastasized to distant lymph nodes. An 85-year-old female patient was admitted with a 7-cm-sized colonic mass invading the duodenum, detected by computed tomography. Positron emission tomography revealed fluorodeoxyglucose uptake in the colon, duodenum, and aortocaval lymph nodes. A large encircling mass in the ascending colon and an ulcerated mass in the duodenum were revealed by colonoscopy and esophagogastroduodenoscopy, respectively. Pathologic examinations of the colon and the duodenum revealed nonglandular, diffusely infiltrating atypical round cells, confirming undifferentiated carcinoma of the colon. The histologic type of this tumor was distinguished using immunohistochemical (IHC) markers. Finally, microscopic characteristics and IHC markers aided in identifying the histologic type of colorectal cancer.

• The Journal of Internal Korean Medicine
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• v.44 no.3
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• pp.585-593
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• 2023

Objective: The purpose of this study is to report the effect of integrative medicine on recurrent follicular lymphoma, thus providing a clinical basis for integrative medicine. Methods: The medical report of a patient with follicular lymphoma who had undergone several chemotherapies but continuously relapsed before treated with integrative medicine was analyzed. Radiologic outcome was assessed by several imaging tests based on Response Evaluation Criteria in Solid Tumors. Clinical outcome and safety were assessed by laboratory tests. Results: After five years of integrative treatment, there was a complete response in imaging tests such as computed tomography (CT), positron-emission tomography/CT, and endoscopy. There were no toxicity in the laboratory test and no serious side effect of integrative medicine. Conclusion: This study suggested that integrative medicine has few side effects but significant effects on treating recurrent follicular lymphoma. However, the results should be taken cautiously as further clinical studies are needed.

• The Journal of Internal Korean Medicine
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• v.44 no.3
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• pp.562-577
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• 2023

Objectives: This is a five-year survival and complete response (CR) report on pancreatic cancer treated with western medicine and Korean traditional medicine. Method: A 59-year-old woman diagnosed with pancreatic cancer visited ○○ Korean traditional medicine hospital after neoadjuvant chemotherapy and pylorus-preserving pancreaticoduodenectomy. She was treated with Korean traditional medicine, including acupuncture, abdominal moxibustion, wild ginseng pharmacopuncture, and herbal medicine, which was based on integrated medicine therapy (IMT), from March 2018 to September 2022. The tumor size was measured by scanning with computed tomography (CT), magnetic resonance imaging, and positron-emission tomography/CT. Adverse events were evaluated using laboratory conclusion and National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. Result: During four years and three months of treatment, IMT maintained safety. The patient finally reached five-year survival without any recurrence or complication (CR) on October 26, 2022. Conclusion: We suggest that an integrative approach including Korean traditional medicine can be a meaningful treatment option for pancreatic cancer. Further studies should be performed to establish the proper treatment protocol of integrative medicine for pancreatic cancer.

• The Journal of Internal Korean Medicine
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• v.44 no.4
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• pp.765-773
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• 2023

Objective: This long-term case report details a case of pancreatic cancer with lung metastasis suppressed by integrative cancer medicine (IMT). Methods: A 64-year-old woman diagnosed with pancreatic cancer visited a Korean medicine hospital complaining about the side effects of chemotherapy for lung metastasis. She received IMT involving Korean traditional medicine and Western immunotherapy from May 2017 to June 2023. Tumor dimensions were assessed through computed tomography (CT) and positron-emission tomography/CT scans, while tumor markers and safety were monitored by laboratory tests. Results: IMT suppressed the progression of cancer, as observed by imaging and laboratory tests. The patient achieved 5-year survival, even after discontinuing chemotherapy. Conclusion: This case presents a potential therapeutic alternative for patients who are ineligible for chemotherapy or surgical interventions.

• Journal of Yeungnam Medical Science
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• v.40 no.4
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• pp.435-441
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• 2023

Pheochromocytomas and paragangliomas (PPGLs) may secrete hormones or bioactive neuropeptides such as interleukin-6 (IL-6), which can mask the clinical manifestations of catecholamine hypersecretion. We report the case of a patient with delayed diagnosis of paraganglioma due to the development of IL-6-mediated systemic inflammatory response syndrome (SIRS). A 58-year-old woman presented with dyspnea and flank pain accompanied by SIRS and acute cardiac, kidney, and liver injuries. A left paravertebral mass was incidentally observed on abdominal computed tomography (CT). Biochemical tests revealed increased 24-hour urinary metanephrine (2.12 mg/day), plasma norepinephrine (1,588 pg/mL), plasma normetanephrine (2.27 nmol/L), and IL-6 (16.5 pg/mL) levels. ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/CT showed increased uptake of FDG in the left paravertebral mass without metastases. The patient was finally diagnosed with functional paraganglioma crisis. The precipitating factor was unclear, but phendimetrazine tartrate, a norepinephrine-dopamine release drug that the patient regularly took, might have stimulated the paraganglioma. The patient's body temperature and blood pressure were well controlled after alpha-blocker administration, and the retroperitoneal mass was surgically resected successfully. After surgery, the patient's inflammatory, cardiac, renal, and hepatic biomarkers and catecholamine levels improved. In conclusion, our report emphasizes the importance of IL-6-producing PPGLs in the differential diagnosis of SIRS.

• Journal of the Korean Society of Radiology
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• v.83 no.4
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• pp.904-909
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• 2022

Uterine cervical cancer is one of the most common malignancies of the female genital tract. Most recurrent cases of uterine cervical cancer are diagnosed within two years after primary treatment, and late recurrence after a disease-free interval of more than five years is rare. In addition, peritoneal metastases usually present as multifocal discrete nodules in the peritoneal cavity with nodular or diffuse peritoneal thickening. Herein, we report an extremely rare case of late recurrent cervical cancer peritoneal metastasis with an unusual manifestation of a large, solitary necrotic mass in the right subphrenic space on contrast-enhanced CT.