• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2004년도 제29회 추계학술대회 발표논문집
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• pp.91-95
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• 2004

알츠하이머병에서는 전산화 단층촬영영상이나 자기공명영상을 이용하여 구조적, 비특이적 뇌 위축등의 병변을 진단할 수는 있으나 뇌 당대사 및 혈류 분포에 의한 이상 유무를 진단하기 위해서는 단일광자방출 단층촬영술 (single photon emission computed tomography, SPECT) 이나 양전자 방출 단층촬영술 (positron emission tomography, PET)을 이용한 국소 뇌혈류나 뇌 당대사 변화를 관찰한 진단이 필수적이다. 따라서 SEPCT나 PET영상 위에 직접 관심영역(region of interest, ROI)를 그려서 ROI를 관찰하여 해부학적 뇌위축과 국소 뇌혈류나 뇌 당대사 변화를 분석하였으나 ROI 방법은 주관적인 영향과 많은 분석 시간을 요하는 단점이 있다. 따라서 통계적 분석 방법을 이용한 맵핑방법으로 voxel based morphometry 방법을 수행하였고 MMSE 값을 분산분석변수로 하여 영상분석하여 $^{18}$F-labeled 2-deoxyglucose ($^{18}$F-FDG) positron emission tomography(PET)-CT 영상을 분석하였다. MMSE 값을 변수로 분석한 voxel based morphemetry 방법에서는 MMSE 값에 의한 대사저하의 변화는 무의미하였다. 알츠하이머병에서는 측두두정엽(temporoparietal cortex)의 cerebral blood flow, oxygen utilization, glucose metabolism은 줄어들고, 일차시각피질, 일차감각피질, 기저핵, 시상, 소뇌는 유지되며 voxel based morphometry 방법은 알츠하이머병을 분석하는데 유용한 분석방법이다.

• Journal of Korean Neurosurgical Society
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• 제63권3호
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• pp.397-405
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• 2020

Objective : We retrospectively evaluated the efficacy of Gamma Knife radiosurgery (GKS) for recurrent nasopharyngeal carcinoma (NPC) in patients who previously underwent radiotherapy, and analyzed the treatment outcomes over 14 years. Methods : Ten patients with recurrent NPC who had previously received radiotherapy underwent stereotactic radiosurgery using a Gamma Knife^® (Elekta Inc, Atlanta, GA, USA) between 2005 and 2018. The median target volume was 8.2 ㎤ (range, 1.7-17.8), and the median radiation dose to the target was 18 Gy (range, 12-30). The median follow-up period was 18 months (range, 6-76 months). Overall and local failure-free survival rates were determined using the Kaplan-Meier method. Results : The NPCs recurred at the primary cancer site in seven patients (70%), as distant brain metastasis in two (20%), and as an extension into brain in one (10%). The recurrent tumors in seven of the 10 patients (70%) were found on the routine follow-up imaging studies. Two patients presented with headache and one with facial pain. Local failure after GKS occurred in five patients (50%) : two of whom died eight and 6 months after GKS, respectively. No adverse radiation effects were noted after GKS. The 1- and 3-year overall survival rates after GKS were 90% and 77%, respectively. The local failure-free survival rates at 6 months, 1 year, and 3 years after GKS were 80%, 48%, and 32%, respectively. The median interval from GKS to local failure was 8 months (range, 6-12). Univariate analysis revealed that using co-registration with positron emission tomography-computed tomography (PET-CT) and magnetic resonance imaging (MRI) was associated with a lower local failure rate of recurrent NPC (p=0.027). Conclusion : GKS is an acceptable salvage treatment option for patients with recurrent NPC who previously received radiation therapy. PET-CT and MRI co-registration for dose planning can help achieve local control of recurrent NPC.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.387-391
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• 2015

Background: Fluorine-18 deoxyglucose positron emission tomography computed tomography (18F-FDG-PET/CT) and bone scintigraphy (BS) are widely used for the detection of bone involvement. The optimal imaging modality for the detection of bone metastases in hormone receptor positive (+) and negative (-) groups of breast cancer remains ambiguous. Materials and Methods: Sixty-two patients with breast cancer, who had undergone both 18F-FDG-PET/CT and BS, being eventually diagnosed as having bone metastases, were enrolled in this study. Results: 18F-FDG-PET/CT had higher sensitivity and specificity than BS. Our data showed that 18F-FDGPET/CT had a sensitivity of 93.4% and a specificity of 99.4%, whiel for BS they were 84.5%, and 89.6% in the diagnosis of bone metastases. ${\kappa}$ statistics were calculated for 18F-FDGPET/CT and BS. The ${\kappa}$-value was 0.65 between 18F-FDG-PET/CT and BS in all patients. On the other hand, the ${\kappa}$-values were 0.70 in the hormone receptor (+) group, and 0.51 in hormone receptor (-) group. The ${\kappa}$-values suggested excellent agreement between all patient and hormone receptor (+) groups, while the ${\kappa}$-values suggested good agreement in the hormone receptor (-) group. Conclusions: The sensitivity and specificity for 18F-FDG-PET/CT were higher than BS in the screening of metastatic bone lesions in all patients. Similarly 18F-FDG-PET/CT had higher sensitivity and specificity in hormone receptor (+) and (-) groups.

• Journal of Trauma and Injury
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• 제20권1호
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• pp.52-56
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• 2007

Marjolin's ulcer is a rare and often-aggressive cutaneous malignancy that arises in previously traumatized or chronically inflamed skin, particularly after burns. We experienced two cases after burns. Case I involved a forty eight year-old man who had suffered from a flame burn at the parietal scalp area, where had been initially described three years earlier as a full-thickness wound including the pericranium. The man consulted us for a persistent ulcerative and infected wound on the burned lesion during the last 24 months, which turned out on the contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) to be the squamous cell carcinoma with involving the skull and the dura mater. Although the posterior auricular lymph node was enlarged on the ipsilateral side, recent positron emission tomography (PET) CT did not show any metastatic lesion. It was impossible for us to resect the intracranial involvement of the tumor radically, and the postoperative PET CT still showed a focal fluorodeoxyglucose (FDG) uptake around the wall of the superior sagittal sinus. We think that an aggressive combined approach is essential for treatment in early stages for a high success rate, before the intracranial structures are involved because there is no consensus on the treatment for advanced disease, and the results are generally poor. Case 1 also did not involve a radical resection because of the intracranial invasion to the wall of superior sagittal sinus and the possibility of damage to the major cortical veins. He received adjuvant radiotherapy and must be followed periodically. Case 2 involved an eighty six year-old women who suffered from a painful scalp ulcer lesion after flame burns three years earlier. Unlike case 1, neither tumor infiltration into the dura nor lymph node enlargement was observed on the contrast-enhanced computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET) CT. We did a radical resection of the tumor, including the involved bone, and a cranioplasty with bone cement.

• 대한정형외과학회지
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• 제54권2호
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• pp.150-156
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• 2019

목적: 악성 연부조직 종양에 대한 무계획적 절제술 후 잔여 종양의 영상학적 진단의 정확성과 임상적 위험인자를 파악하고자 하였다. 대상 및 방법: 2008년부터 2014년까지 무계획적 종양절제술을 시행 후 재절제술을 받은 98명을 대상으로 하여 분석하였다. 재수술 전 모든 환자의 환부를 조영 증강 자기공명영상(magnetic resonance imaging, MRI)을 이용해 영상의학적으로 평가하였으며 54명의 환자는 전신 양전자 방출 단층촬영(positron emission tomography [PET]/computed tomography)을 시행하였다. 모든 환자는 광범위 절제술 후 병리학적 검사를 시행하였다. 각 변수는 일변량 로지스틱 회귀와 다변량 로지스틱 회귀를 이용하여 분석하였다. 결과: 종양이 근막하에 위치한 경우 잔여 종양의 발생률이 높았다(odds ratio: 3.21, p=0.02, 95% confidence interval: 1.25-8.30). MRI는 잔여종양을 발견하는 데 높은 민감도를 보였다(sensitivity 0.79). 결론: 종양이 근막하에 위치한 경우에는 근막 상부에 위치한 경우보다 잔존암이 남을 가능성이 유의하게 높음을 알 수 있었고, MRI 및 PET 검사의 음성예측도가 매우 낮으므로 음성 판정이 나오더라도 이를 근거로 재수술을 시행하지 않는 것은 정당화될 수 없음을 알 수 있었다.

• 대한정형외과학회지
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• 제54권4호
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• pp.293-301
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• 2019

사지와 몸통의 연부조직 종양은 정형외과 의사가 직면할 수 있는 흔한 문제이다. 비록 연부조직 종양은 대부분 양성이지만 정형외과 의사는 양성과 악성 종양을 구별할 수 있는 특징을 알고 있어야 한다. 연부조직 종양의 임상적 특징 및 역학을 이해하게 되면 올바른 진단 및 수술적인 치료를 할 수 있게 된다. 종양의 크기와 깊이는 종양의 진단을 위해 가장 중요한 요소이다. 종양의 감별 진단을 하기 위해서 우선적으로 상세한 병력청취와 자세한 신체 검사가 필요하며, 이후 단순 방사선 촬영, 초음파, 자기공명영상(magnetic resonance imaging), 양전자 방출 단층촬영술(positron emission tomography), 컴퓨터 단층촬영(computed tomography), 뼈 스캔, 혈관 조영술 등의 다양한 영상 촬영법을 사용하여 종양을 진단하고 진단된 종양의 특성을 확인하여야 한다. 특히 초음파 검사는 외래에서도 쉽게 수행할 수 있어 유용하다. 그러나 검사자의 숙련도에 따라 검사 정확도의 차이가 발생할 수 있다는 단점이 있다. 종양의 생검을 통한 조직검사는 종양에 대한 모든 영상 검사를 시행한 후 최종적으로 시행하는 것이 원칙이다. 조직 검사를 시행할 때는 세심한 주의를 기울여야 하며, 최종적인 진단 후에는 치료를 위해 다각적인 접근을 시행하여야 하며 필요한 경우에는 경험 있는 근골격계 종양전문의사에게 의뢰하는 것이 필요하다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제36권6호
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• pp.303-307
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• 2014

Undifferentiated pleomorphic sarcoma (UPS), previously known as malignant fibrous histiocytoma, occurs commonly in the soft tissues in adult, but is rare in the maxillofacial region. It consists of undifferentiated mesenchymal tumor cells resembling histiocytes and fibroblasts. The purpose of this article is to report a case of UPS in the mandible. A 44-year-old patient presented with a painful growing mass in the mandible of two months' duration. Computed tomography and positron emission tomography-computed tomography revealed an ill-defined heterogenous, hypermetabolic mass about 4 cm in size in the left mandible invading adjacent soft tissues. A left mandiblulectomy and reconstruction with a fibular free flap were performed. Immunohistochemical study gave a diagnosis of UPS. The patient was referred for adjuvant chemotherapy after surgical removal of the tumor.

• 대한약침학회지
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• 제11권2호
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• pp.13-19
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• 2008

Objectives To investigate the therapeutic effects of intravenous cultivated wild ginseng(Panax ginseng C.A. Meyer) pharmacopuncture(CWGP) in treating patients with non-small cell lung cancer(NSCLC). Design Prospective case series. Setting This study was conducted at the East-West Cancer Center of Dunsan Oriental Hospital, Daejeon University. Patients Two non-small cell lung cancer patients. Intervention Two non-small cell lung cancer patients were injected CWGP(20mL/day) mixed with 0.9% normal saline(100mL) intravenously. Each patient received a total of 16 and 9 cycles, respectively. One cycle is composed of 14 days. Outcome Measures The effect of intravenous CWGP was measured by scanning with computed tomography(CT) after every 2 cycle and Positron emission tomography- computed tomography(PET/CT) after every 6 cycles. Response and progression was evaluated using the Response Evaluation Criteria in Solid Tumors(RECIST) Committee classification of complete response(CR), partial response(PR), progressive disease(PD) and stable disease(SD). Results They were treated with intravenous CWGP for 8 and 5 months respectively. time later, each tumor remains stable disease(SD). Conclusion These cases may give us a possibility that intravenous CWGP offers potential benefits for non-small cell lung cancer patients.

• Journal of Chest Surgery
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• 제49권3호
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• pp.218-220
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• 2016

We report a case of inadvertent hoarseness after surgery for primary pulmonary amyloidosis. A 55-year-old male was transferred to our facility due to a lung mass. Chest computed tomography revealed a solitary pulmonary nodule. Positron emission tomography-computed tomography showed fluorodeoxyglucose uptake in the main mass and in the mediastinal lymph nodes. To confirm the pathology of the mass, wedge resection and thorough lymph node dissection were performed via video-assisted thoracic surgery (VATS). No complications except for hoarseness were observed; hoarseness developed soon after surgery and lasted for 3 months. The main mass was diagnosed as amyloidosis, but this was not found in the lymph nodes. In conclusion, VATS wedge resection for peripheral amyloidosis is a feasible and safe procedure. However, mediastinal lymph node dissection is not recommended unless there is evidence of a clear benefit.

• Radiation Oncology Journal
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• 제35권2호
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• pp.180-184
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• 2017

Patients with locally advanced lung cancer and very limited pulmonary function (forced expiratory volume in 1 second $[FEV1]{\leq}1L$) have dismal prognosis and undergo palliative treatment or best supportive care. We describe two cases of locally advanced node-positive non-small cell lung cancer (NSCLC) patients with very limited lung function treated with induction chemotherapy and moderate hypofractionated image-guided radiotherapy (Hypo-IGRT). Hypo-IGRT was delivered to a total dose of 45 Gy to the primary tumor and involved lymph nodes. Planning was based on positron emission tomography-computed tomography (PET/CT) and four-dimensional computed tomography (4D-CT). Internal target volume (ITV) was defined as the overlap of gross tumor volume delineated on 10 phases of 4D-CT. ITV to planning target volume margin was 5 mm in all directions. Both patients showed good clinical and radiological response. No relevant toxicity was documented. Hypo-IGRT is feasible treatment option in locally advanced node-positive NSCLC patients with very limited lung function ($FEV1{\leq}1L$).