• Clinical and Experimental Pediatrics
• /
• v.57 no.6
• /
• pp.278-286
• /
• 2014

Purpose: To evaluate the potential utility of $^{123}I$-metaiodobenzylguanine ($^{123}I$-MIBG) scintigraphy and $^{18}F$-fluorodeoxyglucose ($^{18}F$-FDG) positron emission tomography (PET) for the detection of primary and metastatic lesions in pediatric neuroblastoma (NBL) patients, and to determine whether $^{18}F$-FDG PET is as beneficial as $^{123}I$-MIBG imaging. Methods: We selected 8 NBL patients with significant residual mass after operation and who had paired $^{123}I$-MIBG and $^{18}F$-FDG PET images that were obtained during the follow-up. We retrospectively reviewed the clinical charts and the findings of 45 paired scans. Results: Both scans correlated relatively well with the disease status as determined by standard imaging modalities during follow-up; the overall concordance rates were 32/45 (71.1%) for primary tumor sites and 33/45 (73.3%) for bone-bone marrow (BM) metastatic sites. In detecting primary tumor sites, $^{123}I$-MIBG might be superior to $^{18}F$-FDG PET. The sensitivity of $^{123}I$-MIBG and $^{18}F$-FDG PET were 96.7% and 70.9%, respectively, and their specificity were 85.7% and 92.8%, respectively. $^{18}F$-FDG PET failed to detect 9 true NBL lesions in 45 follow-up scans (false negative rate, 29%) with positive $^{123}I$-MIBG. For bone-BM metastatic sites, the sensitivity of $^{123}I$-MIBG and $^{18}F$-FDG PET were 72.7% and 81.8%, respectively, and the specificity were 79.1% and 100%, respectively. $^{123}I$-MIBG scan showed higher false positivity (20.8%) than $^{18}F$-FDG PET (0%). Conclusion: $^{123}I$-MIBG is superior for delineating primary tumor sites, and $^{18}F$-FDG PET could aid in discriminating inconclusive findings on bony metastatic NBL. Both scans can be complementarily used to clearly determine discrepancies or inconclusive findings on primary or bone-BM metastatic NBL during follow-up.

• The Korean Journal of Nuclear Medicine
• /
• v.30 no.3
• /
• pp.344-350
• /
• 1996

Purpose : Noninvasive imaging of tumor cell proliferation could be helpful in the evaluation of tumor growth potential and could provide an early assessment of treatment response. Radiolabeled thymidine, uridine and adenosine have been used to evaluate tumor cell proliferation. These nucleoside analogs are incorporated into DNA during proliferation. Iodine-131-Iodomethyluridine, an analog of Iodine-131-Iododeoxyuridine, is also involved in DNA/RNA synthesis. The purpose of this study was to develop Iodine-131-Iodomethylurdine and image tumor proliferation using Iodine-131-Iodomethyluridine. Materials and Methods : Radiosynthesis of Iodine-131-5-Iodo-2'-O-methyluridine (Iodine-131-Iodomethyluridine) was prepared from 10 mg of 2'-O-methyluridine(Sigma chemical Co., St. Louis, Missouri) and 2.1 mCi(SP. 10Ci/mg) of Iodine-131-labeled sodium iodide in $100{\mu}l$ of water using iodogen reaction. Female Fischer 344 rats were inoculated in the thigh area with breast tumor cells(13765 NF, $10^5$ cells/rat S.C.). After 14 days, the Iodine-131-Iodomethyluridine $10{\mu}Ci$ was injected to three groups of rats(3/group). The percent of injected dose per gram of tissue weight was determined at 0.5-hours, 2-hours, 4-hours, and 24-hours respectively. Tumor bearing rats after receiving Iodine-131-Iodomethyluridine($50{\mu}Ci$ IV) were euthanized at 2 hours after injection. Autoradiography was done using freeze-dried $50{\mu}m$ coronal section. After injection of Iodine-131- Iodomethyluridine ($10{\mu}Ci$/rat, IV) in three breast tumor-bearing rats, planar scintigraphy was taken at 45 minutes, 90 minutes and 24 hours. Results : Iodine-131-Iodomethyluridine was conveniently synthesized using iodogen reaction. The biodistribution showed fast blood clearance and the tumor-to-tissue uptake ratios showed that optimal imaging time was at 2 hours postinjection. Autoradiogram and planar scintigram indicated that tumor could be well visualized. Conclusion : The findings suggest that Iodine-131-Iodomethyluridine, a new radio-iodinated nucleoside, has potential use for evaluation of active regions of tumor growth.

• The Korean Journal of Nuclear Medicine
• /
• v.35 no.3
• /
• pp.117-124
• /
• 2001

Serum thyroglobulin measurement and I-131 whole-body scintigraphy (WBS) are well-established methods for the detection of recurrence in the follow-up of patients with thyroid carcinoma. However, inconsistent results are observed frequently, and these two methods are not always able to detect recurrence. In some patients, serum thyroglobulin level is elevated but the WBS is negative, because the recurrent tumor is too small and below the sensitivity of the diagnostic scan, or there is a dissociation between thyroglobulin synthesis and the iodine frapping mechanism. In such cases, various nuclear imaging methods including Tl-201 Tc-99m-sestamibi, and F-18-FDG PET can be used besides anatomical imaging methods. Among them, FDG PET localizes recurrent lesions in WBS-negative thyroid carcinoma with high accuracy. Several studies have suggested that empirical high-dose I-131 therapy resulted in a high rate of visualization in post-therapy scans with evidence of subsequent improvement. An important question is when to operate on patients with recurrent tumor. We believe that surgical removal is the best means of treatment for patients with localized persistent tumor, despite the high-dose I-131 therapy. with tumor in thyroid remnant, and with isolated recurrence in the lymph node, lung or bone. In addition, we recommend palliative resection of locally unresectable mass with subsequent treatment with high-dose I-131 therapy. Before I-131 therapy, the evaluation of sodium-iodide symporter expression in thyroid carcinoma can predict iodine uptake. Retinoic acid is known to induce redifferentiation, and to enhance I-131 uptake in thyroid carcinoma. Retinoic acid therapy may represent an alternative approach before high-dose I-131 therapy.

• Journal of Digestive Cancer Research
• /
• v.4 no.2
• /
• pp.51-57
• /
• 2016

The epidemiology of pancreatic neuroendocrine neoplasms (PNENs) in Asia has been clarified through epidemiological studies, including one conducted in Japan, and subsequently another in South Korea. As endoscopic ultrasonography (EUS) has become more widely accessible, endoscopic ultrasound-fine needle aspiration (EUS-FNA) has been performed in pancreatic tumors for which the clinical course was only monitored previously. This has enabled accurate diagnosis of pancreatic tumors based on the 2010 WHO classification; as a result, the number of patients with an accurate diagnosis has increased. Although surgery has been the standard therapy for PNENs, new treatment options have become available in Japan for the treatment of advanced or inoperable PNENs; of particular note is the recent introduction of molecular target drugs (such as everolimus and sunitinib) and streptozocin. Treatment for progressive PNENs needs to be selected for each patient with consideration of the performance status, degree of tumor differentiation, tumor mass, and proliferation rate. Somatostatin receptor (SSTR)-2 is expressed in many patients with neuroendocrine tumor. Somatostatin receptor scintigraphy (SRS), which can visualize SSTR-2 expression, has been approved in Japan. The SRS will be a useful diagnostic tool for locating neuroendocrine neoplasms, detecting distant metastasis, and evaluating therapy outcomes. In this manuscript, we review the latest diagnostic methods and treatments for PNENs.

• Journal of the Korean Society of Radiology
• /
• v.84 no.6
• /
• pp.1244-1256
• /
• 2023

In prostate cancer, the bone is the most common site of metastasis, and it is essential to evaluate metastatic bone lesions to assess the tumor burden and treatment response. Castration-resistant prostate cancer refers to the state wherein the cancer continues to progress despite a significant reduction of the sex hormone level and is associated with frequent distant metastasis. The Prostate Cancer Working Group 3 (PCWG3) released guidelines that aimed to standardize the assessment of treatment effects in castration-resistant prostate cancer using bone scintigraphy. However, these guidelines can be challenging to comprehend and implement in practical settings. The purpose of this review was to provide an overview of a specific image acquisition method and treatment response assessment for bone scintigraphy-based evaluation of bone lesions in metastatic castration-resistant prostate cancer, in accordance with the PCWG3 guidelines.

• Nuclear Medicine and Molecular Imaging
• /
• v.42 no.sup1
• /
• pp.76-90
• /
• 2008

$^{18}F-FDG$ PET in combination with conventional imaging modalities could help avoid unnecessary biopsy for the primary mass, and it also has a high diagnostic accuracy in patients with dense breasts. In the assessment of metastasis, $^{18}F-FDG$ PET was useful to select patients who required sentinel lymph node biopsy and to detect extra-axillary lymph node metastasis and distant metastasis. To increase the sensitivity for osteoblastic bone metastasis, bone scintigraphy should be added. In the detection of recurrence, $^{18}F-FDG$ PET showed a higher diagnostic accuracy than tumor marker or computed tomography, and therefore it can be used in routine breast cancer follow-up. $^{18}F-FDG$ PET has been reported that it correctly predicted the response of neoadjuvant chemotherapy on as early as 8th day of treatment. Therefore, it is useful for the early detect of therapeutic response in advanced breast cancer.

• The Korean Journal of Nuclear Medicine
• /
• v.35 no.6
• /
• pp.389-392
• /
• 2001

Tc-99m HMPAO WBC scintigraphy is a highly sensitive and specific method for detection and localization of infection and abscess formation. Nevertheless, WBC accumulation in some neoplastic lesions has been reported. We experienced a case with unusual increased uptake of Tc-99m HMPAO WBC in chondrosarcoma. Although the exact cause ms unclear, the possible mechanism is discussed.

• The Korean Journal of Nuclear Medicine
• /
• v.35 no.4
• /
• pp.268-273
• /
• 2001

Thymoma is the most common primary tumor of anterior mediastinum, accounting for 20% to 30% of all mediastinal tumors. The recurrence rate after total resection of the thymoma ranges 8% to 18%. We reported one patient of recurrent malignant thymoma imaged with Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA. Early and delayed Tc-99m MIBI and Tc-99m Tetrofosmin scintigraphies showed an increased uptake in the mediastinal area. Also, Tc-99m (V) DMSA scintigraphy revealed an increased uptake tn the corresponding area. Coronal SPECT images of Tc-99m MIBI, Tc-99m Tetrofosmin and Tc-99m (V) DMSA revealed increased uptake of each radiopharmaceutical in the tumor lesion corresponding to the mediastinal lesion on the chest CT. However, the normal blood pool activities of the heart and great vessels of Tc-99m (V) DMSA obscured the recurrent malignant thymoma. Although Tc-99m (V) DMSA is a useful tumor seeking agent, we recommend Tc-99m MIBI and Tc-99m Tetrofosmin SPECT rather than Tc-99m (V) DMSA to detect primary and recurrent malignant thymoma.

• The Journal of the Korean bone and joint tumor society
• /
• v.18 no.1
• /
• pp.45-49
• /
• 2012

Skip lesion is not uncommon feature in osteosarcoma and considered to be importantly associated with poor prognosis factor, and thus, should be excised with the main mass. The accurate pre-operative evaluation of the intramedullary extent of osteosarcoma is essential, because it determines the level of bone resection. Among the reliable detection methods, bone scan has a drawback of high rate of false negative results and regional MRI has a difficulty to cover the whole involved lesions without clinical suspicion. The authors report a case of osteosarcoma of the distal femur with a proximal skip lesion that was not detected by either regional MR imaging or by bone scan, but which was visualized by FDG-PET/CT.

• Journal of Radiopharmaceuticals and Molecular Probes
• /
• v.3 no.2
• /
• pp.80-84
• /
• 2017

Re-188 is an excellent and practical radioisotope produced by W-188/Re-188-generator for therapy. We prepared Re-188-tin colloid for therapy of various diseases and tried to treat peritoneal effusion in animal model. Sarcoma-180 cells were injected into ICR mice to induce peritoneal effusion and the mice were grown for 3 d. Re-188-tin colloids (0.25, 0.5, and 1 mCi/mL per 30 g body weight) were injected into the mice and the mice were grown for 90 d. Planar gamma scintigraphy showed even distribution of Re-188-tin colloid radioactivity. Bax expression was found to be dose dependent to Re-188-tin colloid. Normal saline treated group showed the shortest survival time. Among the treated groups, 0.5 mCi dose group showed the longest survival time. In conclusion, Re-188-tin colloid was prepared successfully and showed the feasibility to use as a peritoneal effusion treatment in mice.