Purpose: T1-201 SPECT has been used in differentiating benign and malignant pulmonary lesions. While its sensitivity may be high, the specificity and predictive values are reported to be variable depending on the type of benign lung lesion. The purpose of this study was to prospectively assess the efficacy of T1-201 SPECT for differentiating benign and malignant single pulmonary lesion in a population with a high prevalence of benign pulmonary lesion, especially, tuberculosis. Materials and Methods: One-hundred thirty-three patients, having 89 malignant and 44 benign lesions(23 active tuberculosis, 5 inactive tuberculosis, 3 aspergil-loma, 3 focal pneumonia, 2 thymoma, and 8 others), were imaged using a dual-headed system at 15 minute(early) and 3 hour (delayed) following administration of 111MBq T1-201. The images were read visually and lesion-to-background ratios(L/B) were obtained from transverse tomographic slices. Retention index was expressed as [(delayed L/B- early L/B) $\div$ early L/B]. Results: 82/89(92%) and 83/89(93%) of the malignant lesions were visually positive on the early and delayed images, and 27/44(61%) and 26/44(59%) of the benign lesions were also visually positive on both images. Although a statistically significant difference was found between the mean L/B's of the malignant and benign lesions, L/B was not useful for differentiating the two due to a large overlap. There was no difference in retention indices. Conclusion: Despite of its high sensitivity, the specificity of T1-201 SPECT was unacceptably low in patients with active benign lesions. The positive and negative predictive values for lung cancer in a population with a high prevalence of the benign single pulmonary lesion was only marginal.
Park, Seok-Gun;Lee, Yeon-Hee;Rhyu, Jin-Woo;You, Sun-Mee
The Korean Journal of Nuclear Medicine
/
v.32
no.2
/
pp.151-160
/
1998
Purpose: Piccolo et al. advocated the usefulness of $^{99m}Tc$-MDP breast scan in differential diagnosis of breast mass with high accuracy. But there are little or no follow-up studies about it as we know. We studied $^{99m}Tc$-MDP uptake pattern and lesion/background ratio in patients complaining palpable breast lesions to evaluate the clinical usefulness of $^{99m}Tc$-MDP scan. Materials and Methods: Total 34 patients were studied with physical examination, mammo-gram and $^{99m}Tc$-MDP scan prospectively. Anteroposterior and both lateral view of breast were obtained 5 minutes after iv injection of 740 MBq $^{99m}Tc$-MDP. Breast uptake pattern of $^{99m}Tc$-MDP was analyzed by a grade system: 0=no uptake, grade 1=bilateral diffuse uptake, grade 2=asymmetric faint uptake, grade 3=focal hot uptake. 20 cases were pathologically confirmed by excision biopsy or aspiration biopsy. 14 cases were normal in physical examination and mammogram. Results: Pathologic results showed 7 carcinomas, 6 benign solid tumors, and 7 fibrocystic changes. Grade 3 pattern of $^{99m}Tc$-MDP uptake was noted in 4/7 carcinomas, 3/6 benign solid tumors, and 1/7 fibrocystic changes. Grade 2 pattern was 217, 0/7, 3/7 respectively. The average L/B ratio was 1.66 in carcinomas, 1.68 in benign solid masses, 1.20 in fibrocystic diseases, 1.05 in normal patients. L/B ratio was higher in carcinoma and benign mass groups than in fibrocystic change and normal control groups(p=0.005). But there was no statistical difference between L/B ratio of malignant mass group and benign mass group. Conclusion: $^{99m}Tc$-MDP scan is not suitable to routine clinical use for breast mass diagnosis. It might be used in limited conditions when whole body bone scan is planned.
Kim, Tae-Hyung;So, Yong-Seon;Kweon, Ki-Hyeon;Han, Sang-Woong;Kim, Seok-Hwan;Kim, Jong-Soon;Han, Seung-Soo
The Korean Journal of Nuclear Medicine
/
v.30
no.1
/
pp.130-138
/
1996
Bone scan is known to be an effective tool for observing the state of soft tissues and bones of electric burn patients. It is also used for observing the progress of patients after debridement or skin graft as well as deforming to amputate specific body parts. To evaluate bone scan's role in electric burn, we analyzed bone scan 37 patients with electric burn. Among the 37 patients, 8 of 37 were injured in low voltage and 29 of them in high voltage. 27 patients received the electrical input through the hand, 6 through the scalp, 2 through the shoulder, 1 through the left chest wall and 1 through the left inguinal area. Among 29 patients received high voltage, 22 patients had the electrical output through the foot, 3 through the hand, 2 through the shoulder, 1 through the buttock and 1 through the left chest wall. Bone scans revealed cellulitis in 37 patients with 47 sites, osteomyelitis in 15 patients with 15 sites & bone defects in 4 patients with 4 sites. In 4 patients with skin graft or skin flap, follow up bone scan showed improvements of bony uptake in preoperatively bony defect area and all of them were healed without complication. There were 2 cases in which uptake increased in the myocardium, 1 in the liver and 6 in the kidney, however, serum calcium level, EKG, cardiac enzyme, liver and renal function tests were normal. In conclusion, bone scans are helpful in the assessment of injury sites after electrical insult and in differential diagnosis of cellulitis and osteomyelitis. It is also useful tool of assessment after skin graft or skin flap, however, it should be further evaluated about internal organ damage.
Purpose: We have evaluated characteristics of adrenal masses incidentally observed in nonenhanced F-18 FDG PET/CT of the oncologic patients and the diagnostic ability of F-18 FDG PET/CT to differentiate malignant from benign adrenal masses. Materials and Methods: Between Mar 2005 and Aug 2008, 75 oncologic patients (46 men, 29 women; mean age, $60.8{\pm}10.2$ years; range, 35-87 years) with 89 adrenal masses incidentally found in PET/CT were enrolled in this study. For quantitative analysis, size (cm), Hounsfield unit (HU), maximum standardized uptake value (SUVmax), SUVratio of all 89 adrenal masses were measured. SUVmax of the adrenal mass divided by SUVliver, which is SUVmax of the segment 8, was defined as SUVratio. The final diagnosis of adrenal masses was based on pathologic confirmation, radiologic evaluation (HU<0 : benign), and clinical decision. Results: Size, HU, SUVmax, and SUVratio were all significantly different between benign and malignant adrenal masses.(P < 0.05) And, SUVratio was the most accurate parameter. A cut-off value of 1.0 for SUVratio provided 90.9% sensitivity and 75.6% specificity. In small adrenal masses (1.5 cm or less), only SUVratio had statistically significant difference between benign and malignant adrenal masses. Similarly a cut-off value of 1.0 for SUVratio provided 80.0% sensitivity and 86.4% specificity. Conclusion: F-18 FDG PET/CT can offer more accurate information with quantitative analysis in differentiating malignant from benign adrenal masses incidentally observed in oncologic patients, compared to nonenhanced CT.
Purpose: $^{18}$F-flurodeoxyglucose (FDG) uptake on positron emission tomography (PET) scan has been found to reflect tumor aggressiveness and prognosis in various types of cancer. However, pattern of FDG uptake in biliary malignancies and its clinical significance have not been studied well. The purpose of this study was to assess the additional value of $^{18}$F-FDG PET in differential diagnosis and prognosis of cholangiocarcinoma (CC) according to the tumor location and tumor morphology. Materials and Methods: From April 2005 to May 2008, eighty two patients (M:F = 55:27, age 66.2$\pm$9.6 yrs) with CC underwent $^{18}$F-FDG PET. For semiquantitative analysis, the maximum standardized uptake value (SUV$_{max}$) was obtained from the primary tumor. The difference of SUV$_{max}$ according to the tumor location and tumor growth pattern, such as scirrhous type, nodular type, polypoid type were compared. Results: Overall sensitivity of PET scan was 81.7% in CC. SUV$_{max}$ on PET scan in intrahepatic CC was significantly higher compared to extrahepatic CC. In extrahepatic CC, polypoid type showed significantly higher SUV$_{max}$ compared to scirrhous type. Conclusion: $^{18}$F-FDG PET may have a significant impact on clinical decision-making and on the management of intrahepatic cholangiocarcinoma. And it is related to the shape of the tumor and the sensitivity of detection is higher in the mass-forming type than in the scirrhous type.
Kim, Jin-Suk;Lim, Seok-Tae;Jeong, Young-Jin;Kim, Dong-Wook;Jeong, Hwan-Jeong;Sohn, Myung-Hee
Nuclear Medicine and Molecular Imaging
/
v.43
no.4
/
pp.309-316
/
2009
Purpose: F-18 FDG can be accumulated in the liver, bowel, kidney, urinary tract, and muscles physiologically. The aim of this study was to evaluate the clinical value of dual time point 18F-FDG PET /8 imaging for the differentiation of the colonic focal uptake lesions. Materials and Methods: One hundred thirty two patients (M:F = 77:55, Age 62.8$\pm$11.6 years) underwent $^{18}$F-FDG PET/CT at two time points, prospectively: early image at 50-60 min and delayed image at 4-4.5 hours after the intravenous injection of $^{18}$F-FDG. Focally increased uptake lesions on early images but disappeared or shifted on delayed images defined a physiological uptake. For the differential evaluation of persistent focal uptake lesions on delayed images, colonoscopy and histopathologic examination were performed. SUVmax changes between early and delayed images were also compared. Results: Among the 132 patients, 153 lesions of focal colonic uptake were detected on early images of $^{18}$F-FDG PET/CT. Of these, 72 (47.1%) lesions were able to judge with physiological uptake because the focal increased uptake disappeared from delayed image. Among 81 lesions which was showed persistent increased uptake in delayed image, 61 (75.3%) lesions were confirmed as the malignant tumor and 14 (17.3%) lesions were confirmed as the benign lesions including adenoma and inflammatory disease. Remaining 6 (7.4%) lesions were confirmed as the physiological uptake because there was no particular lesion in the colonoscopy. In the malignant lesions, the calculated dual time point change for SUVmax ($\Delta$%SUVmax) was 20.8$\pm$18.7%, indicating a significant increase in SUVmax between the two point (p<0.01). In contrast, the change in SUVmax for the non-malignant lesions including benign lesions and physiological uptake was -13.7%$\pm$24.2%. For the differentiation of the malignant and non-malignant focal colonic uptake lesions, $\Delta$%SUVmax was the most effective parameter, and the cut-off value using -5% provided the best sensitivity, specificity, and accuracy. Conclusion: The dual time point $^{18}$F-FDG PET/CT imaging with SUVmax change evaluation could be an important noninvasive method for the differentiation of malignant and benign focal colonic uptake lesions including physiologic uptake.
Kim, Hae-Won;Won, Kyoung-Sook;Zeon, Seok-Kil;Kim, Jin-Hee
Nuclear Medicine and Molecular Imaging
/
v.43
no.4
/
pp.287-293
/
2009
Purpose: This study is to evaluate rib fractures on bone scan in breast cancer patients treated with breast cancer surgery and radiation therapy and to evaluate its relation with radiation therapy and operation modality. Materials and Methods: Two hundred seventy cases that underwent serial bone scan after breast cancer surgery and radiation therapy were enrolled. Bone scan and chest a findings of rib fracture were analyzed. Results: The rib uptake was seen in 74 of 270 cases (27.4%) on bone scan and 50 cases (18.5%) were confirmed to have rib fracture by chest CT. The rate of modified radical mastectomy in patients with rib fracture was significantly higher than that in patients without rib fracture (66.0% vs. 27.0%, p = 0.000). The rate of additional radiation therapy to axillar or supraclavicular regions in patients with rib fracture was significantly higher than that in patients without rib fracture (62.0% vs. 28.6%, p =0.000). Rib fracture was seen most frequently at 1-2 years after radiation therapy (51.9%) and single rib fracture was seen most frequently (55.2%). Of total 106 rib fractures, focal rib uptake was seen in 94 ribs (88.7%) and diffuse rib uptake was seen in 12 ribs (11.3%). On one year follow-up bone scan, complete resolution of rib uptake was seen in 15 ribs (14.2%). On chest a, the rate of fracture line in ribs with intense uptake was significantly higher than that in ribs with mild or moderate uptake (p = 0.000). The rate of presence of fracture line in ribs with focal uptake was significantly higher than that in ribs with diffuse uptake (p = 0.001). Conclusion: Rib fracture in breast cancer patients after radiation therapy was related to radiation portal and operation modality. It should be interpreted carefully as a differential diagnosis of bone metastasis.
Panax ginseng has been used as a traditional medicine for several centuries in Korea. A laboratory experiment using methanol extracts of freeze-dried leaves and roots in the different ages of P. ginseng was conducted to determine the content of phenolics and flavonoids, antioxidant activity and cytotoxicity. The results indicate that the total phenolics level [mg ferulic acid equivalents (FAE) $kg^{-1}$ DW] was higher in leaves (22.0 to 76.3 mg $kg^{-1}$) than roots (19.0 to 28.3 mg $kg^{-1}$) of P. ginseng. The total content of phenolics in roots increased with increase in age of P. ginseng from one to six years. However, the content of phenolics in P. ginseng leaf decreased with the increase in age. Total flavonoid [mg naringin equivalents $kg^{-1}$ DW] was more detected in the leaves (30.3 to 138.6 mg $kg^{-1}$) than in the roots (0.0 to 10.6 mg $kg^{-1}$) of P. ginseng. The total flavonoid level in leaves decreased with increase in age of P. ginseng. The antioxidant potential of the methanol extracts from the plants dose-dependently increased. DPPH free radical scavenging activity was higher in leaves (36.9 to 82.8%) than in roots (14.8 to 39.4%), and in young plants than in old ones. According to 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay, the methanol extracts from 5 year-root part showed the highest cytotoxicity against Calu-6, followed by 2 year- and 3 year-roots. However, the methanol extracts from 6 year- and 4 year-roots had lower cytotoxicity. Total phenolics content in both leaves and roots was highly correlated with the DPPH radical scavenging ($r^2=0.7366$ to 0.7870) and nitrite scavenging ($r^2=0.5604$ to 0.8794) activities, suggesting that they contribute to the antioxidant properties of the P. ginseng plants.
The Geodo mine area, had been developed for Fe and Cu ores since 1963 and abandoned in recent decades, is located in the central part of the Taebaeksan mineralized district. This area comprises of the Jangsan, Myobong, Pungchon, Hwajeol, Dongjeom, and Dumugol Formations in ascending stratigraphic order. These Formations were intruded by the Cretaceous Eopyeong granitoids that appears to produce the Geodo skarn. Their compositions are relatively oxidized quartz monzodiorite to granodiorite (magnetite series, $Fe_2O_3/FeO=0.3{\sim}1.1$). Mineralizations related skarn deposit occur in the Myobong, Pungchon, and Hwajeol Formations. The proximal skarn is zoned from andraditic garnet ($Ad_{44-95}Gr_{1-53}$) predominant adjacent to the Eopyeong granitoids to diopsidic pyroxene ($Hd_{10-100}Di_{0-89}$) predominant away from the one. The differential proportion of garnet and pyroxene is generated by water/rock ratio and their source, such as magmatic and meteoric water. This is useful tool for assessment the overall oxidation state of the entire skarn system. Gold occurs in proximal red to brownish garnet skarn, and genetically associated with Bi- and Te-bearing minerals. Skarn deposit developed in the Geodo mine area is considered as oxidized Au skarn category, based on chemical composition of the Eopyeong granitoids, zonation of skarn, and gold occurrences. Garnet-rich skarn zone will be the main target for exploration of gold in the study area. However, it is needed to the detailed survey on vertical zonation of this area as well as lateral zonation. The result of this survey would provide an important basis for the exploration of the skarn Au deposit in the Geodo mine area.
It has been known that ras signaling transduction leads to cell proliferation and migration including various adaptor molecules. Dynamin protein has been implicated in the formation of nascent vesicles in both the endocytic and secretory pathways. Dynamin was classified into three isoforms: dynamin I is only expressed in neuronal tissue, dynamin II is expressed ubiquitously in all tissue but that of dynamin III is confined to testis. We have reported in previous study that Grb2, binding to ras, was associated with dynamin II in NIH3T3 cells. Therefore we have tried to identify the relative expression of dynamin II according to overexpressed ras protein in ras oncogene transfected cells (NIH3T3 (ras)). For the detection of differential expression of dynamin II, we have used immunofluorescent staining and western blot methods in NIH3T3 and NIH3T3 (ras) cells. Next we have described the morphological differences between NIH3T3 and NIH3T3 (ras) cells using SEM and TEM. From these experiments dynamin II was highly expressed in NIH3T3 (ras) cells. NIH3T3 cells was transformed to more spindle shape with many cell process by transfection of ras oncogene. Moreover dynamin II was more concentrated in endocytotic membrane of the NIH3T3 (ras) cells compared to that of NIH3T3 cells. The present results suggested that dynamin II may involve the intermediate messenger in Ras signaling transduction pathway.
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