• 제목/요약/키워드: hypermetabolism

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일측 성대마비 환자의 보상기전에 관여하는 후두내근육 : PET-CT 융합 영상을 사용한 정상군과의 발성시 및 비발성시의 비교 (Hypermetabolism of Compensatory Laryngeal Muscles in Unilateral Vocal Cord Palsy: Comparison Study between Speech and Silence with Normal Subjects by Co-registered PET-CT Fusion Images)

  • 배문선;김현경;김한수
    • Nuclear Medicine and Molecular Imaging
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    • 제40권1호
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    • pp.23-27
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    • 2006
  • 목적: 일측성 성대마비 환자의 FDG-PET에서 영상 판독에 오류를 일으킬 수 있는 성대의 비대칭 섭취가 여러 차례 보고되었다. 저자들은 일측 성대마비 환자와 정상인에서 발성시와 침묵시의 성대근육의 활동정도를 FDG의 섭취로 비교하여 보았다. 방법 : 11명의 일측 성대마비 환자와(원인:thyroidectomy=7, lung cancer=1, others=3) 12 명의 정상인을 대상으로 FDG-PET 을 시행하였다. 이들을 각각 두그룹으로 나누어 발성군은 FDG 주사후 20분간 책을 읽고 비발성군은 평소 검사와 같이 발성을 금하였다. 성대근육을 5부위로 나누어 SUV를 측정하였고 이를 위해 최근 시행한 CT와 융합 영상을 만들었다. 결과: 일측성대마비환자는 건측 갑상피열근에 높은 섭취를 보였으며 발성군은($SUV=5.88{\pm}2.65$) 비발성군에 비하여($SUV=2.30{\pm}0.39$) 유의하게 높은 섭취를 보였다. 정상군에서는 발성시 외윤상피열근에 대칭적인 FDG 섭취증가를 보였고 후위의 피열간근이 가장 높은 섭취($SUV=3.68{\pm}0.96$)를 보였다. 결론: 발성시 FDG-PET 검사를 하면 일측 성대마비환자와 정상인은 각각 서로 다른 후두근육에 FDG 섭취를 보였다. PET-CT 영상 융합을 사용하여 일측 성대마비 환자의 보상에 관여하는 후두근육의 비대칭적인 FDG섭취를 이해하는 것이 영상 판독에 도움을 줄 수 있을 것이다.

전신성 홍반성 루푸스에서 F-18 FDG PET상 기저핵 포도당대사 증가 소견을 보이는 무도병 1예 (Chorea in Systemic Lupus Erythematosus: Evidence for Bilateral Putaminal Hypermetabolism on F-18 FDG PET)

  • 서욱장;정선미;고수진;이창근;김재승;임주혁;유빈;문희범
    • 대한핵의학회지
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    • 제37권5호
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    • pp.325-330
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    • 2003
  • Purpose: We describe a 54-year-old woman with systemic lupus erythematosus (SLE) who suddenly presented with chorea and had positive antiphospholipid antibodies. F-18 FDG PET showed abnormally increased glucose metabolism in bilateral putamen and primary motor cotex. Tc-99m ECD SPECT also showed abnormally increased regional cerebral blood flow in bilateral putamen. She was treated with corticosteroid and aspirin after which the symptoms improved. Four months later, follow up F-18 FDG PET showed improvement with resolution of hypermetabolism in bilateral putamen. This case suggests that striatal hypermetabolism is associated with chorea in SLE.

진행성 간암 환자에서 편도 전이에 FDG 섭취증가를 보인 예 (A Case of Metastatic Tonsillar Lesion Showing Increased FDG Uptake in the Patient with Advanced Hepatocellular Carcinoma)

  • 박정미;김희경;김상균;김영석
    • Nuclear Medicine and Molecular Imaging
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    • 제42권1호
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    • pp.70-73
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    • 2008
  • A 65 year-old man with hepatocellulcar carcinoma (HCC) admitted to treat left lower leg swelling and pus discharge suspecting osteomyelitis. MRI of his lower leg revealed the bone metastasis. Whole body FDG PET/CT additionally detected left shoulder and right ilium metastasis. Hematemesis suddenly developed in this patient after 3 weeks. Metastasis of right tonsil was histologically proven. When we reviewed his FDG PET/CT, there was asymmetric mild hypermetabolism in the right tonsil. When focal hypermetabolism is shown in the organ physiologically taking glucose up such as tonsil, we should cautiously assess whole body PET/CT in the examination of distant metastasis. We present a patient with multiple distant metastasis including tonsil from HCC showing increased FDG uptake with the literature review.

네거티브 경구 조영제를 이용한 PET/CT 촬영시 나타난 종양성 섭취와 유사한 생리적 장관 섭취 (Colon Cancer Mimicking Physiologic FDG Uptake : with Using of Negative Oral Contrast)

  • 정영진;강도영
    • Nuclear Medicine and Molecular Imaging
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    • 제40권3호
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    • pp.186-187
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    • 2006
  • A 64-year-old female with glioblastoma multiforme (GBM) was assigned to our department for whole body PET/CT scan. She ingested 1 liter of pure water as negative oral contrast just before PET/CT examination. FDG-PET/CT images showed a very intense hypermetabolic, focal lesion in the abdominal cavity around descending colon. The SUVmax of the lesion was 17.2. But there was no abnormal lesion corresponded to the area of PET scan in the combined contrast enhanced CT scan. We suggested considering a malignant lesion due to very intense glycolytic activity. Conventional abdominal CT scan & colonoscopy were accomplished within one week after PET/CT evaluation. There was no abnormality in both examinations. We executed follow-up PET/CT evaluation after 1 month and couldn't find any abnormality around the corresponding area. So we concluded the hypermetabolism was colonic physiologic uptake. A colonic physiologic uptake is a well known cause of false positive finding. Nuclear physicians should be considered the possibility of malignancy when interpret focal colonic uptake, especially incidental finding. There are a few reports that using of negative oral contrast is able to reduce gastrointestinal physiologic uptakes. But as we can see in this case, although we used negative oral contrast, intense physiologic uptake is detected and maxSUV is able to up to 17.2. So, it is important to keep a fact in mind. Even though there is a colonic physiologic uptake in PET/CT image, it may be able to show very intense hypermetabolism regardless of using negative oral contrast.

Case Report of Prostate Cancer Patient with Only Lymph Node Involvement on F-18 FDG PET/CT

  • Jung, Hyun Jin;Kang, Sungmin
    • 고신대학교 의과대학 학술지
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    • 제33권3호
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    • pp.391-395
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    • 2018
  • We report a case of a patient with locally advanced prostate cancer who had only lymph node involvement without bone metastasis on F-18 FDG PET/CT. A 62-year-old Korean male was admitted to our hospital due to dysuria. His PSA level on admission was 79.35 ng/mL. A transrectal ultrasound-guided prostate biopsy confirmed prostate cancer and his Gleason score was 10 (5+5). F-18 FDG PET/CT demonstrated a hypermetabolic mass lesion with SUVmax 7.0 in the prostate and hypermetabolism with SUVmax 4.7 of the abdominal and pelvic lymph nodes. Tc-99m HDP bone scan showed no significant bone metastasis. The patient underwent hormonal therapy for 9 months. Follow-up F-18 FDG PET/CT showed significantly reduced size and FDG uptake in the prostate and abdominal and pelvic lymph nodes. In this case, treatment monitoring with F-18 FDG PET/CT showed decreased mass size and FDG uptake in the prostate and abdominal and pelvic lymph nodes.

비소세포폐암 환자의 양전자방출 단층촬영에서 골수 대사활성도의 항암화학요법에 대한 반응 예측 (Association between Bone Marrow Hypermetabolism on 18F-Fluorodeoxyglucose Positron Emission Tomography and Response to Chemotherapy in Non-Small Cell Lung Cancer)

  • 설희윤;목정하;윤성훈;김지은;김기욱;박혜경;김성장;김윤성;이민기;박순규
    • Tuberculosis and Respiratory Diseases
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    • 제66권1호
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    • pp.20-26
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    • 2009
  • 연구배경: 양전자방출 단층촬영은 최근 폐암의 진단과 병기 결정에 널리 사용된다. 본 연구에서는 비소세포폐암 환자에서 양전자방출 단층촬영에서의 골수 대사활성도의 증가가 항암화학요법에 대한 반응과 관련성이 있는지 알아보고자 하였다. 방 법: 조직학적으로 비소세포폐암으로 진단 받은 환자 중에 양전자 방출 단층촬영을 시행한 후 일차 항암화학 요법을 시행 받은 환자를 대상으로 하였다. 대상군의 양전자 방출 단층촬영상 골수 대사활성도는 요추 1, 2, 3번의 FDG 섭취를 측정하여 평가하였고, 항암화학요법에 대한 반응은 Response Evaluation Criteria in Solid Tumors (RECIST)를 이용하여 평가하였다. 결 과: 총 59명의 환자가 포함되었다. 대상군을 양전자 방출 단층촬영상 골수의 SUV가 1.37 이상인 군(21명, 35.6%)과 미만인 군(38명, 64.4%)으로 나누었고, 골수의 SUV와 간의 SUV의 비가 0.73 이상인 군(22명, 37.3%)과 미만인 군(37명, 62.7%)로 나누어 일차 항암화학요법에 대한 반응을 비교하였다. 골수의 SUV와 골수의 SUV와 간의 SUV의 비는 일차 항암화학요법에 대한 반응과 통계학적으로 유의한 차이가 없었다(p=0.142, 0.978). 결 론: 비소세포폐암 환자에서 양전자방출 단층촬영에서 나타난 골수 대사활성도는 항암화학요법에 대한 반응과 관련성이 없었다.

본태성 진전에서 시각의 영향 (Visual Cues in Essential Tremor)

  • 서만욱
    • Annals of Clinical Neurophysiology
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    • 제2권2호
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    • pp.114-118
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    • 2000
  • Purpose : The pathophysiology of essential tremor(ET) remains unknown. PET studies of ET showed some conflicting data. One study reported significant glucose hypermetabolism of the medulla and thalami, but other studies reported abnormal bilateral overactivity of cerebellar and red nuclear connections. The previous experimental studies suggested that each PET finding reflects a part of neural circuit which is responsible for ET. So it can be imagined that olivocerebellar oscillation may be transmitted by the way of cerebellar projections to the thalamus in ET. It has been reported that the cerebellar dentate nucleus neurons are involved in the generation and/or guidance of movement based on visual cues. The purpose of this study is to clarify the role of dentato-thalamic tract in ET. Methods : Tremor amplitudes were recorded as each patient perform two kinds of task, one involving sensory-guided movement and the other involving memory-guided movement. Each patient was asked to move his/her index finger following a smoothly moving target. He/She also was asked to perform the same movements with his/her eyes closed ET. Results : The results showed that average amplitudes of tremor were significantly higer during visually guided task than during memory guided task in ET patients. Conclusions : Our results led us to conclude that dentato-thalamic tract might be related to the control of tremor in ET.

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경정영양과 중심정맥영양을 공급받는 환자에서 질병의 상태(APACHEIII Score), 과대사 정도가 영양상태 및 임상적 결과에 미치는 영향 (Effects of the APACHEIII Score, Hypermetabolic Score on the Nutrition Status and Clinical Outcome of the Patients Administered with Total Parenteral Nutrition and Enteral Nutrition)

  • 라미용;김은미;조영연;서정민;최혜미
    • 대한지역사회영양학회지
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    • 제11권1호
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    • pp.124-132
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    • 2006
  • The aim of this study is to evaluate the clinical outcome. Between January 1,2002 to September 30, 2002, we prospectively and retrospectively recruited III hospitalized patients who received Enteral Nutrition (EN group n = 52) and Total Parenteral Nutrition (TPNgroup n = 59) for more than seven days. The factors of clinical outcomes are costs, incidences of infection, lengths of hospital stay, and changes in weight. The characteristics of patients were investigated, which included nutritional status, disease severity CAP ACHE III score) and hypermetabolic severity Chypermetabolic score). Hypermeta-bolic scores were determined by high fever (> $38^{\circ}C$), rapid breathing (> 30 breaths/min) , rapid pulse rate (> 100 beats/min), leukocytosis (WBC > 12000 $mm^{3}$), leukocytopenia (WBC > 3000 $mm^{3}$), status of infection, inflammatory bowel disease, surgery and trauma. There was a positive correlation between hypermetabolic score and length of hospital stay (ICU), medical cost, weight loss, antibiotics adjusted by age while APACHEIII score did not show correlation to clinical outcome. Medical cost was higher by $18.2\%$ in the TPN group than the EN group. In conclusion, there was a strong negative correlation between the clinical outcome (cost, incidence of infection, hospital stay) and hypermetabolic score. Higher metabolic stress caused more malnutrition and complications. For nutritional management of patients with malnutrition, multiple factors, including nutritional assessment, and evaluation of hypermetabolic severity are needed to provide nutritional support for critically ill patients.

Dosimetric Verification for Primary Focal Hypermetabolism of Nasopharyngeal Carcinoma Patients Treated with Dynamic Intensity-modulated Radiation Therapy

  • Xin, Yong;Wang, Jia-Yang;Li, Liang;Tang, Tian-You;Liu, Gui-Hong;Wang, Jian-She;Xu, Yu-Mei;Chen, Yong;Zhang, Long-Zhen
    • Asian Pacific Journal of Cancer Prevention
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    • 제13권3호
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    • pp.985-989
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    • 2012
  • Objective: To make sure the feasibility with $^{18F}FDG$ PET/CT to guided dynamic intensity-modulated radiation therapy (IMRT) for nasopharyngeal carcinoma patients, by dosimetric verification before treatment. Methods: Chose 11 patients in III~IVA nasopharyngeal carcinoma treated with functional image-guided IMRT and absolute and relative dosimetric verification by Varian 23EX LA, ionization chamber, 2DICA of I'mRT Matrixx and IBA detachable phantom. Drawing outline and making treatment plan were by different imaging techniques (CT and $^{18F}FDG$ PET/CT). The dose distributions of the various regional were realized by SMART. Results: The absolute mean errors of interest area were $2.39%{\pm}0.66$ using 0.6cc ice chamber. Results using DTA method, the average relative dose measurements within our protocol (3%, 3 mm) were 87.64% at 300 MU/min in all filed. Conclusions: Dosimetric verification before IMRT is obligatory and necessary. Ionization chamber and 2DICA of I'mRT Matrixx was the effective dosimetric verification tool for primary focal hyper metabolism in functional image-guided dynamic IMRT for nasopharyngeal carcinoma. Our preliminary evidence indicates that functional image-guided dynamic IMRT is feasible.