• The Journal of Korean Medicine
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• v.31 no.1
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• pp.130-137
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• 2010

Objectives: So far it has been reported that acupuncture increases cerebral blood supply and stimulates the functional activity of brain nerve cells. Previous studies have demonstrated that frequently used electro-acupuncture (EA) therapies for stroke increased regional cerebral blood flow (rCBF) in normal volunteers. Though ST 36-ST 41 EA is another prevailing therapy for stroke, there had been no report about its effect on rCBF. This study was to evaluate the effect of ST 36-ST 41 EA on rCBF in normal volunteers using single photon emission computed tomography (SPECT) and statistical parametric mapping (SPM). Methods: In the resting state, $^{99m}Tc$-ECD brain SPECT scans were performed on 10 normal volunteers (5 males, 5 female, mean age $23.6{\pm}0.5$ years). On the other study day, 7 days after the resting examination, 15 minutesEA were applied at ST 36 and ST 41 on the right side of the subjects. Immediately after ST36-ST41 EA, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of rCBF after EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by SPM with a threshold of p = 0.01, uncorrected (extent threshold: k=100 voxels). Results: EA applied at the right ST36-ST41 significantly increased rCBF in the right inferior parietal lobule (Brodmann area [BA] 40), right retrosubicular area (BA 48), left inferior parietal lobule (BA 40), left middle temporal gyrus (BA 21), left fusiform gyrus (BA 37), left inferior parietal lobule (BA 39), left inferior temporal gyrus (BA 20), and left somatosensory association cortex (BA 7). However, right ST36-ST41 EA significantly decreased rCBF in the right parahippocampal gyrus (BA 35), right cerebellum, left frontopolar area (BA 10), left orbitofrontal area (BA 11), left dorsolateral prefrontal cortex (BA 9), and left dorsal anterior cingulate cortex (BA 32). Conclusions: These results demonstrate that rightST36-ST41 EA increased rCBF prominently in both inferior parietal lobule (BA 40) and right retrosubicular area (BA 48), which suggest that there be correlation between specific EA and corresponding rCBF.

• The Korean Journal of Nuclear Medicine
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• v.28 no.3
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• pp.282-292
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• 1994

Brain perfusion SPECT shows typical regional perfusion abnormalities in Alzheimer's disease(AD) and is useful for its diagnosis. However, there is also arguement that these patterns show significant overlap with other causes, and the accuracy for SPECT in differentiating AD has shown conflicting results. We postulate that the variation in re-ported results are partly due to a difference in patient or control selection with special reference to the mixture of ischemic cerebral disease in the studied population. To deter-mine the effect of ischemic lesions and the nature of control subjects on SPECT studies for AD, we performed $^{99m}Tc$-HMPAO single photon emission computed tomography (SPECT) in 11 probable AD patients with a low (<4) Hachinski ischemic score and 12 non-demented age matched controls. Magnetic resonance imaging(MRI) disclosed ischemic cerebral lesions in 27% (3/11) of the PAD group and 25% (3/12) of the control group. Regional perfusion indices were quantitated from the SPECT images as follows and the distribution of perfusion indices from both groups were compared. This was repeated with controls after excluding those with significant ischemic lesions by MRI : regional perfusion index = average regional count/average cerebellar count All PAD patients showed perfusion abnormality in SPECT. However, 53% (10/12) of controls also showed perfusion at-normalities, and no pattern could reliably differentiate the two groups. After excluding controls with significant cerebral ischemia, the difference in temporal and parietal perfusion index was increased. A decreased tempore-parietal and any parietal or temporal per-fusion index had a sensitivity of 18% and 36% in detecting AD, respectively. When using a separate group of normal age mathced controls, the indices showed an even more difference in the temporal and parietal lobes and the sensitivity of a decreased tempore-parietal and any parietal or temporal perfusion index had a sensitivity of 36% and 55% in detecting AD, respectively. Thus, the type of control with special reference to the pres-once of ischemic cerebral lesions contribute significantly to the accuracy of perfusion SPECT in diagnosing AD. This nay have particular importance in the diagnosis of AD in populations where the prevalance of cerebrovascular disease is high.

• The Korean Journal of Nuclear Medicine
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• v.33 no.2
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• pp.120-130
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• 1999

Purpose: This study was performed to evaluate the diagnostic usefulness of double-phase Tc-99m MIBI parathyroid scintigraphy with single photon emission computed tomography (SPECT) in patients with hyper-parathyroidism. We also evaluated the relationship between Tc-99m MIBI uptake and oxyphil cell contents in parathyroid glands. Materials and Methods: The subjects were 28 parathyroid glands of 10 patients who underwent Tc-99m MIBI parathyroid scintigraphy and parathyroidectomy for clinically suspected hyper-parathyroidism. Early and delayed pinhole images were obtained at 15 minutes and 2 hours after injection of Tc-99m MIBI, and SPECT images were followed. The weight and oxyphil cell contents of parathyroid tissue were obtained from pathologic specimen, and the scintigraphic findings were compared with histopathology. Results: In surgical histopathology, 6 parathyroid adenomas and 9 parathyroid hyperplasias were confirmed. The sensitivity, specificity, and positive predictive value of early and delayed images were 46.7% (7/15), 76.9% (10/13), 70% (7/10) and 66.7% (10/15), 92.3% (12/13), 90.9% (10/11), respectively. SPECT image detected an additional small hyperplasia.. The sensitivity, specificity, and positive predictive value of combined interpretation of early and delayed images with SPECT were 73.3% (11/15), 100% (13/13), 100% (11/11). The sensitivity was 100% (6/6) for adenoma, whereas that was 55.5% (5/9) for hyperplasia. Both adenomas and hyperplasias showed significantly increased oxyphil cell contents compared with normal parathyroid glands (p<0.0001), but the oxyphil cell content and weight were not significantly different between adenomas and hyperplasias. Conclusion: Double-phase Tc-99m MIBI parathyroid scintigraphy with SPECT is useful for lesion localization in patients with hyperparathyroidism. Although both adenoma and hyperplasia have increased oxyphil cell content, the sensitivity is high in adenoma, but low in hyperplasia.

• Tuberculosis and Respiratory Diseases
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• v.73 no.5
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• pp.273-277
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• 2012

Paraneoplastic limbic encephalitis (PLE) is a rare syndrome characterized by memory impairment, affective and behavioral disturbances and seizures. Among many different neoplasms known to cause PLE, small cell lung cancer (SCLC) is the most frequently reported. The pathogenesis is not fully understood but is believed to be autoimmune-related. We experienced a patient with typical clinical features of PLE. A 67-year-old man presented with seizure and disorientation. Brain magnetic resonance imaging demonstrated high signal intensity in the bilateral amygdala and hippocampus in flair and T2-weighted images suggestive of limbic encephalitis. Cerebrospinal fluid tapping revealed no evidence of malignant cells or infection. Positron emission tomography/computed tomography showed a lung mass with pleural effusion and a consequent biopsy confirmed the diagnosis of PLE associated with SCLC. The patient was subsequently treated with chemotherapy and neurologic symptoms gradually improved.

• Journal of Digital Convergence
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• v.10 no.2
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• pp.243-247
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• 2012

Beam hardening artifact happens in the CT image. when a PET/CT is conducted while there is a metallic dental implant. The artifact appears in the CT image can affect the PET image. When the patient with head and neck cancer has a metallic dental implant, Beam hardening artifact which was taken in th CT image can change the PET image and SUV value. Therefore, by Quantitative measure of the SUV according to the change in HU by the metallic dental implant, the appropriacy in the clinical application was assessed. The records of 47 patients with PET/CT August 2011. For the analysis, 2 region of interest were defined in area where CT and PET image. As a result of the experiment, if there in an implant, the HU and the SUV increased and there existed a statistically significant difference(p<0.01). Although this level of increase was not large compared with that in the patient who have no metallic dental implant, when a person has head and neck cancer, it is even more likely to be overestimated when diagnosing the cancer. When conducting PET/CT for the patient who have head and neck cancer, the physical biological parts should be considered in order not to make an error in decoding.

• Radiation Oncology Journal
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• v.33 no.2
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• pp.126-133
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• 2015

Purpose: To evaluate the outcomes of adjuvant radiotherapy (RT) and to analyze prognostic factors of survival in the International Federation of Gynecology and Obstetrics (FIGO) IB-IIA uterine cervical cancer. Materials and Methods: We retrospectively reviewed the medical records of 148 patients with FIGO IB-IIA uterine cervical cancer who underwent surgery followed by adjuvant RT at the Yonsei Cancer Center between June 1997 and December 2011. Adjuvant radiotherapy was delivered to the whole pelvis or an extended field with or without brachytherapy. Among all patients, 57 (38.5%) received adjuvant chemotherapy either concurrently or sequentially. To analyze prognostic factors, we assessed clinicopathologic variables and metabolic parameters measured on preoperative 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). To evaluate the predictive performance of metabolic parameters, receiver operating characteristic curve analysis was used. Overall survival (OS) and disease-free survival (DFS) were analyzed by the Kaplan-Meier method. Results: The median follow-up period was 63.2 months (range, 2.7 to 206.8 months). Locoregional recurrence alone occurred in 6 patients, while distant metastasis was present in 16 patients, including 2 patients with simultaneous regional failure. The 5-year and 10-year OSs were 87.0% and 85.4%, respectively. The 5-year and 10-year DFSs were 83.8% and 82.5%, respectively. In multivariate analysis, pathologic type and tumor size were shown to be significant prognostic factors associated with both DFS and OS. In subset analysis of 40 patients who underwent preoperative PET/CT, total lesion glycolysis was shown to be the most significant prognostic factor among the clinicopathologic variables and metabolic parameters for DFS. Conclusion: Our results demonstrated that adjuvant RT following hysterectomy effectively improves local control. From the subset analysis of preoperative PET/CT, we can consider that metabolic parameters may hold prognostic significance in early uterine cervical cancer patients. More effective systemic treatments might be needed to reduce distant metastasis in these patients.

• Journal of Yeungnam Medical Science
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• v.30 no.2
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• pp.116-119
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• 2013

A burnt-out prostate cancer tumor is a very rare clinical entity. The term 'burnt-out' refers to a primary tumor that has spontaneously and nearly completely regressed without treatment. Since metastasis of prostate cancer is usually encountered in the presence of advanced disease, distant metastasis with an undetectable primary tumor is very rare. We report herein a case of a burnt-out prostate cancer tumor that metastasized to the thoracic (T) spine and caused cord compression. A 66-year-old man visited the Emergency Department due to weakness of both legs for the past two days. His blood and urine tests were normal at the time. His spine magnetic resonance imaging (MRI) scans looked like bone metastasis that involved the T-7 vertebral body and a posterior element, and caused spinal cord compression. Other images, including from the brain MRI, neck/chest/abdomino-pelvic computed tomography (CT) scan and 18F-fluorodeoxyglucose (FDG)-positron emission tomography (PET) and endoscopy, revealed no lesions that suggested malignancy. After total corpectomy T-7 and screw fixation/fusion at T5 to T10, the pathology report revealed a metastatic carcinoma that was strongly positive for prostate-specific antigen (PSA). The serum PSA value was 1.5 ng/mL. The transrectal 12-core prostate biopsy and ultrasonography showed no definitive hypoechoic lesion, but one specimen had slight (only 1%) adenocarcinoma with a Gleason score of 6 (3+3). The final diagnosis was burned-out prostate cancer with an initial normal PSA value. Although metastatic disease with an unknown primary origin was confirmed, a more aggressive approach in seeking the primary origin could provide a more specific treatment strategy and greater clinical benefit to patients.

• Tuberculosis and Respiratory Diseases
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• v.73 no.6
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• pp.320-324
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• 2012

A 55-year-old woman was admitted for an elevated serum carbohydrate antigen-125 (CA-125) level, and a left pleural effusion, which were detected at a routine health examination. Computed tomography of the chest was performed upon admission, revealing extensive bilateral paratracheal and mediastinal lymph node enlargement with a massive left-sided pleural effusion. Subsequent analysis of the pleural fluid demonstrated consistency with an exudate, no evidence of malignant cells, and a normal adenosine deaminase. However, the pleural fluid and serum CA-125 levels were 2,846.8 U/mL and 229.5 U/mL, respectively. A positron emission tomography did not reveal any primary focus of malignancy. Finally, a surgical mediastinoscopic biopsy of several mediastinal lymph nodes was performed, revealing non-necrotizing granulomas, consistent with sarcoidosis. After a month of treatment of prednisolone, the left pleural effusion had resolved, and after 2 months the serum CA-125 level was normalized.

• Investigative Magnetic Resonance Imaging
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• v.12 no.2
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• pp.89-99
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• 2008

Imaging assessment of prostate cancer is one of the most difficult sections of oncology imaging. Detecting, localizing and staging of the primary prostate cancer by preoperative imaging are still challenging for the radiologist. Magnetic resonance (MR) imaging provides excellent soft tissue contrast and is widely used for solid organ imaging, but results of preoperative imaging of the prostate gland with conventional MR imaging is unsatisfactory. Positron emission tomography and computed tomography (PET/CT) is the cornerstone in oncology imaging, but some limitations prohibit the assessment of primary prostate cancer with PET or PET/CT. Recent studies to overcome these insufficient accuracies of imaging evaluation of primary prostate cancers with advanced MR techniques and PET and PET/CT are reported. In this article, we review the imaging findings of prostate cancer on variable modalities, focused on MR imaging and PET/CT.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.8
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• pp.3333-3338
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• 2015

Background: This study was conducted to analyze positron emission tomography (PET) / computed tomography (CT) and magnetic resonance imaging (MRI) performance with oropharyngeal non-Hodgkin's lymphoma (ONHL).Materials and Methods: The complete image data of 30 ONHL cases were analyzed, all patients were performed PET / CT and MRI examination before the treatment, with the time interval of these two inspections not exceeding 14 days. The distribution, morphology, MRI signal characteristics, enhancement feature, standardized uptake value (SUV) max value and lymph node metastasis way of the lesions were analyzed. Results: Among the 30 cases, 23 cases were derived from the B-cell (76.7%), 5 cases were derived from the peripheral T cells (16.7%) and 2 cases were derived from the NK/T cells (6.7%). 19 cases exhibited the palatine tonsil involvement (63.3%). As for the lesion appearance, 10 cases appeared as mass, 8 cases were the diffused type and 12 cases were the mixed type. 25 cases exhibited the SUVmax value of PET / CT primary lesions as 11 or more (83.3%). MRI showed that all patients exhibited various degrees of parapharyngeal side-compressed narrowing, but MRI still exhibited the high-signal fat, and the oropharyngeal mucosa was intact. 25 cases were associated with the neck lymph node metastasis, among who 22 cases had no necrosis in the metastatic lymph nodes, while the rest 3 cases exhibited the central necrosis in the metastatic lymph nodes. Conclusions: PET / CT and MRI have important value in diagnosing and determining the lesion extent of ONHL.