• Journal of Yeungnam Medical Science
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• 제20권2호
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• pp.117-128
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• 2003

Thallium-201 scintigraphy is used to discriminate the malignant bone tumor from the benign by qualitatively and quantitatively, and to predict the response of preoperative chemotherapy in osteosarcoma, by comparing the changes of thallium uptake ratio after chemotherapy to the tumor necrosis ratio. Thallium-201 scintigraphy scan should be done prior to surgical biopsy. PICKER Prism 2000 gamma camera with high resolution parallel hole collimator is usually used for scanning. The patient is injected with 2-3mCi of Tl-201 and the early phase is checked in 30 minutes and delayed phase in 3 hours. The scan images are visually evaluated by a blinded nuclear medicine physician. We could evaluate true positive, true negative, false positive and false negative by the comparison of results with those of biopsy, and calculate positive and negative predictive value(%), sensitivity(%), specificity(%) and diagnostic accuracy(%). For the quantitative analysis of thallium uptake, we drew the region of interest on the tumor side and contralateral normal side as mirror image, and calculated the uptake ratio with dividing the amount of gamma count in tumor side by normal side. We could calculate the percent changes of thallium uptake ratio in early and delayed phase, and compare them to the ratio of tumor necrosis. Thallium-201 scintigraphy proved as useful imaging study to discriminate malignant bone tumor from benign, but had exception in giant cell tumor and low grade malignant bone tumors. We can use T1-201 scan to differentiate the benign from the malignant tumor, and to evaluate the response of preoperative chemotherapy or radiotherapy, and to determine the residual tumor or local recurrence. For the better result, we need to have a more detail information about false positive cases and a more objective and quantitative reading technique.

• 대한골관절종양학회지
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• 제9권1호
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• pp.45-51
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• 2003

목적: 골종양이 의심되는 환자들에게 탈륨 스캔을 시행하여 섭취 정도를 정량적으로 측정하고 비교 분석하여 탈륨 스캔의 악성 골종양 조직에 대한 판별 능력을 규명하고자 한다. 대상 및 방법: 골종양이 의심되는 82명의 환자에 대하여 조직 생검 전에 다른 영상검사와 함께 전향적으로 탈륨 스캔을 시행하였다. 스캔의 결과는 정성적 판독과 정량적 탈륨 섭취율을 측정하였으며, retention index(delayed/early phase의 탈륨 섭취량)를 구하였다. 결과의 분석을 위하여 고등급 악성 골종양 군, 양성 골종양 군, 거대세포종 군 및 저등급 악성 골종양 군으로 나누고 각 그룹간의 통계적 유의성을 조사하였다. 결과: 탈륨 섭취율의 정량적 측정에서는 고등급 악성 골종양 군에서는 early phase에 평균 4.14, delayed phase에서는 평균 2.26였으며, 양성 골종양 군에서는 각각 1.16과 1.09, 거대세포종 군에서는 3.15와 1.94, 저등급 악성 골종양 군에서는 1.41과 1.31이었다. Retention index는 고등급 악성 골종양 군에서는 평균 0.62, 양성 골종양 군에서는 0.97, 거대세포종 군에서는 0.66, 저등급 악성 골종양 군에서는 0.93이었다. 고등급 악성 골종양 군은 early phase와 delayed phase의 탈륨 섭취율이 거대세포종을 제외한 양성 골종양 군 보다 유의하게 높았으며(p<0.001), retention index는 유의하게 낮았다(p<0.001). 결론: 탈륨 스캔은 악성 골종양과 대부분의 양성 골종양을 구분 할 수 있는 유용한 검사라고 사료되지만, 거대세포종의 경우 악성 골종양 같이, 저등급 악성 골종양의 경우 양성 골종양 같이 나타나는 특성에 유의하여 사용하여야 할 것이다.

• 대한핵의학회지
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• 제37권5호
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• pp.336-339
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• 2003

Purpose: A 6-year-old boy with osteogenic sarcoma of the left humerus underwent bone scintigraphy. Tc-99m MDP was accumulated not only in the primary tumor but also in the osseous and extraosseous (pulmonary and pericardial) metastases. Osteogenic sarcoma directly produces osteoid, both in the primary and metastatic lesions. Tc-99m MDP is avidly taken up by tumor osteoid. At initial presentation, only 2% of cases have both pulmonary and osseous metastases. The patient had osseous, pulmonary, and pericardial metastases at presentation. This case presents that increased uptakes of Tc-99m MDP by the primary and metastatic tumor were demonstrated on bone scintigraphy at presentation.

• 대한핵의학회지
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• 제32권4호
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• pp.374-381
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• 1998

목적: 종양을 영상화하기 위해서 I-131-Iododeoxyadenosine (IAD)을 방사합성하여 유방세포가 접종된 쥐를 대상으로 생체분포를 확인하고 신티그라피, 자가방사영상을 시행하여 종양에 잘 섭취되는지를 관찰하였다. 대상 및 방법: Tosyl acetyladenosine을 acetonitrile에 녹인 후 I-131-NaI를 첨가하고 가열하여 IAD를 합성하였다. Female Fisher 344 rat에 유방세포를 피하에 접종하고 3주 후 IAD 0.37 MBq를 주입하고 0.5, 1, 2, 4 및 24시간 후에 각각 3마리씩 희생시켜 주요 장기를 적출하여 %ID/g를 구하였다. 2마리 쥐에 IAD 1.11 MBq를 주입하고 각각 2, 24 시간에 신티그라피를 시행한 후 희생시켜 carboxy-methylcellulose로 블록을 만들어 동결절편기로 $100{\mu}m$ 절편을 얻어 2, 24시간에 각각 자가방사영상을 얻었다. 결과 종양의 섭취(%ID/g)는 주사 후 0.5, 1, 2, 4 및 24시간에 각각 0.74, 0.13, 0.55, 0.38, 0.05이었다. 주사 후 1시간에 종양의 섭취는 심장 (0.34), 간(0.33), 비장(0.47), 신장(0.69), 근육(0.14), 뼈(0.33), 소장(0.51)보다 높았으나, 혈액(1.06), 폐(0.77), 갑상선(177.71)보다는 낮았다. 주사 후 4시간까지 종양의 섭취는 끈 변화가 없었다. 종앙/근육 섭취비는 주사 후 0.5, 1, 2, 4 및 24시간에 각각 4.65, 5.11, 4.91, 4.94 4.10이었고 종양/혈액 섭취비는 주사 후 0.5, 1, 2, 4 및 24시간에 각각 0.68, 0.69, 0.64, 0.67, 0.57로서 섭취비는 시간이 지나도 개선되지는 않았다. 주사 후 2, 24시간에 시행한 신티그라피 및 자가방사영상에서 종양을 잘 관찰 할 수 있었다. 결론: 이 결과는 IAD를 사용하여 종양을 영상화 할 수 있음을 시사하나 종양에의 집적(국소화)을 개선하는 방법이 모색되어야 하겠고 IAD를 이용한 종양영상이 종양세포의 증식을 반영하는지 확인하는 연구가 더 필요할 것으로 사료된다.

• 대한핵의학회지
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• 제21권1호
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• pp.25-32
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• 1987

Authors analysed biochemical studies and scintigraphic findings of obstructive jaundice and nonobstructive jaundice in 44 cases of $^{99m}Tc-DISIDA$ scintigraphy with nonvisualization of biliary excretion till 120 min or 240 min after injection of $^{99m}Tc-DISIDA$. Causative diseases of $^{99m}Tc-DISIDA$ scintigraphy with nonvisualization of biliary excretion were in order to choledocholithiasis (25%), hepatitis (25%), cholangiocarcinoma (14%), cholangitis (14%) and pancreas head tumor (11%). In obstructive jaundice, statistically significant findings were elevated alkaline phosphatase above 300 IU/L on biochemical study and single lobe enlargement of the liver, irregular radioisotope uptake of the liver and concave indentation of the gall bladder fossa of the liver on scintigraphy. In nonobstructive jaundice, statistically significant findings were persistent renal excretion of $^{99m}Tc-DISIDA$ and more increased uptake density of the heart than the liver on scintigraphy.

• Nuclear Medicine and Molecular Imaging
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• 제43권4호
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• pp.366-367
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• 2009

Ga-67 scintigraphy demonstrated increased uptake in the lungs and stomach in a 26-year-old man with hypercalcemia. A primitive neuroectodermal tumor was confirmed by bone marrow examination. Tc-99m MDP uptake in the same locations as Ga-67 revealed by bone scintigraphy was consistent with metastatic calcification. Although the mechanism of Ga-67 uptake in metastatic calcification is not understood, the presence of an inflammatory process is suggested.

• 대한핵의학회지
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• 제21권1호
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• pp.61-68
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• 1987

Investigation with $^{57}Co-Bleomycin$ in patients with the various cancers and in tumor bearing animals are descirbed. In the patients, $^{57}Co-Bleomycin$ appears to be one of the useful tumor-seeking radiopharmaceuticals, and worth applicable to clinical uses. Labelled yield of $^{57}Co-Bleo$ was about 97 % by thin layer chromatography. The pyrogen free tests were performed to meet U.S.P. critical ranges. In clinical studies with $^{57}Co-Bleo$, 4 cases out of 5 patients with lung cancer., 2 cases among 3 thyroid cancer patients, and all 3 hepatoma patients showed positive tumor scans. The patients with stomach cancer, and the esophageal cancer showed false negative scintigraphy. A case with pulmonary tuberculosis showed a positive scan while liver abscess showed a negative picture. The merits of $^{57}Co-Bleomycin$ scintigraphy seems to be its relatively high affinity to tumors and low radiation hazard in spite of long physical half life.

• 대한핵의학회지
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• 제31권1호
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• pp.108-115
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• 1997

NP-59 신티그라피는 부신피질의 기능장애를 선택적으로 영상화할 수 있는 장점이 있기에 다양한 부신질환의 진단에 적응이 되는바 특히 임상검사와 방사선학적 검사 결과가 서로 상이한 경우 진단에 결정적인 도움을 줄 수 있는 기능 검사법이다. 저자는 이러한 장점을 가지고 있는 NP-59 스캔을 부신질환 환자에서 시행하여 그 결과를 임상자료와 비교하여 부신피질 신티그라피의 유용성을 규명해보고자 이 연구를 시행하였다. 본 연구대상으로서 1990년 3월부터 1996년 12월까지 동아대학교병원 핵의학과에서 NP-59 스캔을 시행한 10명의 환자와 그들의 스캔 11예를 대상으로 하여 병력지에 기재된 임상자료와 스캔판독소견을 후향적으로 비교 분석하였다. 대상환자 중 쿠싱병(2예)과 부신종양에 의한 쿠싱증후군(3예)에서는 진단명과 스캔판독소견이 일치하였다. 부신의 부수종양(2예)에서는 1예는 진단명과 판독소견이 일치하였으나 1예에 있어서는 기능성 종양으로 판독되어 불일치를 보였는데 이는 subclinical Cushin-g's syndrome으로 추정되어 관찰중이다. 임상적으로 는 일차성 알도스테론증과 부신성 조모증이 의심되나 부신 CT 검사상 정상소견을 보인 환자에서 이를 확인하기 위하여 덱사메타존 억제스캔을 시행한 결과 정상소견을 보였고 이들은 각각 본태성 고혈압과 간경화증에 동반된 조모증으로 추정되어 치료 및 경과 관찰중이다. 이상의 결과로 보아 NP-59 신티그라피는 쿠싱증후군의 진단과 원인질환의 감별진단에 매우 유용하였으며 비록 대상수가 작아서 결론 내리기는 어려우나 부수종양에서 스캔소견만으로도 전이성 병변을 제외시킬 수 있으므로 결과적으로는 불필요한 생검을 피할 수 있게 하는 임상적인 유용성을 가지고 있었다.

• 대한핵의학회지
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• 제20권1호
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• pp.33-37
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• 1986

It is well known that $^{99m}Tc-sulfur$ colloid or phytate hepatic scintigraphy is highly sensitive but not specific. Both $^{99m}Tc-DISIDA$ and bilirubin have been shown to share the same anionic transport pathway in the liver. Hepatocellular carcinoma(HCC) retains the ability to produce bile but has marked limitation to excreting it resulting in accumulation of bile within the tumor cells. Based upon such a fact, $^{99m}Tc-DISIDA$ hepatobiliary scintigraphy is used for the diagnosis of HCC. The present communication deals with our experience of DISIDA scintigraphic exploration of 9 cases of HCC in a retrospective way. We have made an observation on intensity of positive radio nuclide accumulation in the cold area of HCC as it is demonstrated by phytate scintigraphy. In addition we have semi quantitatively analyzed time-activity pattern and the following results were obtained. (1) All of 9 cases showed an increased uptake of $^{99m}Tc-DISIDA$ in delayed scintigrams. Of these 5 cases showed accumulation less than, 3 equal to, 1 more than the surrounding liver tissue. (2) The mean of the first appearing time of $^{99m}Tc-DISIDA$ activity in tumoral region was 2 hours and 20 minutes. (3) DISIDA scintigraphy provides us with positive informations of diagnostic value.

• Asian Pacific Journal of Cancer Prevention
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• 제14권6호
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• pp.3647-3652
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• 2013

Purpose: To evaluate the diagnostic value of $^{18}F$-FDG PET/CT for detection of bone metastasis in comparison with the efficacies of $^{18}F$-FDG PET/CT, CT, $^{18}F$-FDG PET and conventional planar bone scintigraphy in a series of cancer patients. Methods: Five hundred and thirty patients who underwent both $^{18}F$-FDG PET/CT and bone scintigraphy within 1 month were retrospectively analyzed. The skeletal system was classified into 10 anatomic segments and interpreted blindly and separately. For each modality, the sensitivity, specificity, accuracy, PPV and NPV were calculated and the results were statistically analyzed. Results: Bone metastases were confirmed in 117 patients with 459 positive segments. On patient-based analysis, the sensitivity, specificity, accuracy, PPV and NPV of $^{18}F$-FDG PET/CT were significantly higher than bone scintigraphy, CT and $^{18}F$-FDG PET (P<0.05). On segment-based analysis, the sensitivity of CT, bone scintigraphy, $^{18}F$-FDG PET and $^{18}F$-FDG PET/CT were 70.4%, 89.5%, 89.1% and 97.8%, respectively (P<0.05, compared with $^{18}F$-FDG PET/CT). The overall specificity and accuracy of the four modalities were 89.1%, 91.8%, 90.3%, 98.2% and 90.3%, 90.9%, 89.8%, 98.0%, respectively (P<0.05, compared with $^{18}F$-FDG PET/CT). The PPV and NPV were 89.8%, 87.6%, 85.6%, 97.2% and 85.6%, 93.2%, 92.8%, 98.6%, respectively. Three hundred and twelve lesions or segments were presented as lytic or sclerotic changes on CT images at the corresponding sites of increased $^{18}F$-FDG uptake. In lytic or mixed lesions, the sensitivity of $^{18}F$-FDG PET/CT and $^{18}F$-FDG PET were better than bone scintigraphy, while in osteoblastic lesions bone scintigraphy had a similar performance with $^{18}F$-FDG PET/CT but better than $^{18}F$-FDG PET alone. Conclusion: Our data allow the conclusion that $^{18}F$-FDG PET/CT is superior to planar bone scintigraphy, CT or $^{18}F$-FDG PET in detecting bone metastasis. $^{18}F$-FDG PET/CT may enhance our diagnosis of tumor bone metastasis and provide more information for cancer treatment.