• 대한한의학회지
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• 제31권1호
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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.

• 대한핵의학회지
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• 제28권3호
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• pp.282-292
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• 1994

본 연구에서는 $^{99m}Tc$-HMPAO SPECT를 이용한 AD의 진단에서 허혈성 뇌병변의 유무와 대조군의 선정방법이 진단성적에 미치는 영향을 조사하기 위하여 지역주민을 대상으로 진단된 PAD군 11례와 연령을 맞춘 대조군 12례에서 SPECT를 시행하여 국소 혈류비를 분석하였다. MRI 소견을 조사한 결과 PAD군의 27%(3/11)와 대조군의 25%(3/12)에 유의한 뇌허혈 또는 경색 병변이 관찰되었다. 뇌병변의 유무와 관계없이 두군을 비교한 결과 측두엽이나 두정엽에 평균혈류비의 유의한 차이가 없었으며 두군을 신뢰성있게 감별할 만한 특징적인 혈류양상을 발견하지 못하였다. 그러나 뇌허혈병변이 있는 자를 대조군에서 제외시켰을 때 두군의 측두엽 및 두정엽 혈류비의 차이가 증가하였다. 또 별도로 설정한 건강한 대조군과 비교한 결과 같은 부위의 혈류비에 현저한 차이가 관찰되었다. 이상의 결과로 뇌혈류 SPECT에 의한 AD의 진단성적은 연구대상의 선정에 의해 영향을 받으며 특히 허혈성 뇌병변의 유무는 연구결과에 많은 영향을 미친다고 생각되었다. 향후 허혈성 뇌병변에 의한 영향을 해결하기 위해 SPECT 영상을 방사선학적 검사와 함께 평가하는 방법에 대한 연구가 필요하다고 사료되었다.

• 대한핵의학회지
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• 제33권2호
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• pp.120-130
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• 1999

목적: 갑상선기능항진증 환자에서 병소의 국소화를 위하여 시행하는 Tc-99m MIBI를 이용한 double-phase 부갑상선 신티그라피와 SPECT 방법의 진단적 유용성을 평가하고, 부갑상선의 호산성 세포량과 Tc-99m MIBI 섭취와의 관계를 알고자 하였다. 대상 및 방법: 임상적으로 부갑상선기능항진증이 의심되어 부갑상선 신티그라피가 시행된 16명의 환자중 10명에서 수술이 시행되었고, 여기서 얻은 28개의 부갑상선 조직들을 대상으로 분석하였다. Tc-99m MIBI를 환자에게 정맥주사 후 15분과 2시간에 조기와 지연 바늘구멍 영상을 얻었고 이어서 SPECT 영상을 촬영하였다. 수술로 제거된 부갑상선 조직의 무게와 호산성 세포량을 구하였고, 신티그라피소견을 병리조직 결과와 비교하였다. 결과: 수술로 6개의 부갑상선종과 9개의 부갑상선 비대증이 진단되었다. 조기와 지연 바늘구멍 영상의 민감도, 특이도, 그리고 양성 예측률은 각각 46.7% (7/15),76.9% (10/13), 70% (7/10)과 66.7% (10/15), 92.3% (12/13), 90.9% (10/11)이었다. SPECT 영상은 바늘구멍 영상에 비해 1개의 부갑상선 증식증 병소를 더 진단할 수 있었다. 전체적으로 조기와 지연 바늘구멍 영상과 SPECT 영상을 종합하면 민감도, 특이도, 그리고 양성 예측률은 73.3% (l1/15), 100% (13/13), 100% (11/11)였다. 부갑상선기능항진증의 원인 중부갑상선종은 민감도가 100% (6/6)였으나 부갑상선 증식증은 55.5% (5/9)이었다. 호산성 세포량은 부갑상선종과 부갑상선 증식증에서 정상 부갑상선에 비해 증가되었으나(p<0.0001) 부갑상선종과 부갑상선증식증을 비교하면 호산성 세포량과 무게에는 유의한 차이는 없었다. 결론: Tc-99m MIBI를 이용한 double-phase 부갑상선 신티그라피와 SPECT는 부갑상선기능항진증 환자의 병소 국소화에 효과적인 방법으로 특히 부갑상선종의 국소화에 유용하였다. 부갑상선종과 부갑상선 증식증에서 모두 호산성 세포량이 증가되어 있었으나, 부갑상선종에서는 민감도가 높았고, 부갑상선 증식증에서는 낮았다. 부갑상선증식증에서 민감도가 낮은 원인에 대해서는 더 연구가 필요할 것으로 생각된다.

• Tuberculosis and Respiratory Diseases
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• 제73권5호
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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.

• 디지털융복합연구
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• 제10권2호
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• pp.243-247
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• 2012

금속성 치아충전물이 있을 때 PET/CT검사를 시행하면 CT영상에서 선속경화인공음영이 발생한다. CT영상에 발생되는 인공음영에 의해 PET영상에 영향을 미칠 수 있다. 두경부종양이 있는 환자가 치과용 충전물이 있을 경우 CT영상에서 발생하는 선속경화인공음영에 의해 PET영상 및 SUV값에 변화를 줄 수 있다. 따라서 본 연구는 금속성치아충전물에 의한 HU 값의 변화에 따른 SUV값을 정량적으로 측정하여 임상적용에 있어 적절성을 평가 하였다. 연구대상은 2011년 8월에 PET/CT검사를 실시한 환자 47명이었다. 분석을 위해 CT와 PET영상에 2개의 ROI를 그려 이용하였다. 실험결과 충전물이 있을 경우 HU값과 SUV값이 증가 하였고 통계적으로도 유의한 차이를 보였다.(P<0.01) 이 증가 정도는 금속성 치아충전물이 없는 환자의 경우보다 큰 변화는 아니었지만 두경부 종양이 있을 경우 암의 진단시 과대평가가 될 수 있는 가능성이 충분하다. 따라서 임상에서 두경부 종양이 있는 환자를 대상으로 PET/CT 검사를 시행할 경우 판독상의 오류를 범하지 않도록 여러 물리학적, 생물학적인 부분에 대하여 고려를 해야 할 것이다.

• Radiation Oncology Journal
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• 제33권2호
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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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• 제30권2호
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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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• 제73권6호
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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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• 제12권2호
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• pp.89-99
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• 2008

전립선 암은 종양 영상 분야에서 가장 어려운 분야 중 하나이다. 술전 영상 검사를 통한 전립선 암의 발견 (detection), 정위 (localization) 그리고 병기결정(staging)은 여전히 영상의학과 의사의 도전이 필요한 분야이다. 자기공명 영상은 우수한 연부 조직 대조를 보이며 여러 고형 장기의 영상에 널리 쓰이나, 전립선의 술전 자기공명 영상의 결과는 기대에 미치지 못한다. 전산화단층촬영 영상과 결합된 양전자방출단층촬영술 (PET/CT)은 종양 영상의 발달에 획기적인 기여를 하였으나, 전립선암의 평가에는 어려움이 많다. 최근에 이러한 불충분한 정확도를 극복하기 위하여 발전된 자기공명 영상 기법과 PET/CT을 이용한 전립선암 영상에 대한 연구들이 발표되었다. 본 종설에서는 새로운 기법의 자기 공명 영상과 PET/CT 영상을 중심으로 전립선암의 다양한 영상법과 그 소견을 살펴볼 것이다.

• Asian Pacific Journal of Cancer Prevention
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• 제16권8호
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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.