• The Journal of Internal Korean Medicine
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• v.43 no.4
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• pp.751-760
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• 2022

Objective: To show a decrease in tumor recurrence and improvement in quality of life in patients with recurrent cervical cancer. Method: A 58-year-old female patient diagnosed with recurrent cervical cancer in February 2021 was treated for 14 months with integrative cancer treatment (ICT) to decrease the tumor size and improve chemotherapy-induced peripheral neuropathy (CIPN) and nausea. The patient underwent chemotherapy or concomitant chemoradiation therapy (CCRT) with ICT. Radiologic outcomes were assessed by abdomen & pelvis computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT) based on the Response Evaluation Criteria in Solid Tumors (RECIST) protocol. Clinical outcomes were assessed by the National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), Eastern Cooperative Oncology Group (ECOG), and a numeric rating scale (NRS). Result: During the 14 months of treatment, the size and metabolic activity of the recurrent tumor decreased and underwent partial remission based on RECIST. The NRS scores for CIPN and nausea were improved, and the ECOG score improved from grade 2 to 1. No serious side effects of grade 3 or higher were noted on the NCI-CTCAE test. Conclusion: This case suggests that ICT may have a synergetic effect with chemotherapy or radiotherapy for recurrent cervical cancer.

• BMB Reports
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• v.55 no.6
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• pp.267-274
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• 2022

Molecular imaging is used to improve the disease diagnosis, prognosis, monitoring of treatment in living subjects. Numerous molecular targets have been developed for various cellular and molecular processes in genetic, metabolic, proteomic, and cellular biologic level. Molecular imaging modalities such as Optical Imaging, Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET), Single Photon Emission Computed Tomography (SPECT), and Computed Tomography (CT) can be used to visualize anatomic, genetic, biochemical, and physiologic changes in vivo. For in vivo cell imaging, certain cells such as cancer cells, immune cells, stem cells could be labeled by direct and indirect labeling methods to monitor cell migration, cell activity, and cell effects in cell-based therapy. In case of cancer, it could be used to investigate biological processes such as cancer metastasis and to analyze the drug treatment process. In addition, transplanted stem cells and immune cells in cell-based therapy could be visualized and tracked to confirm the fate, activity, and function of cells. In conventional molecular imaging, cells can be monitored in vivo in bulk non-invasively with optical imaging, MRI, PET, and SPECT imaging. However, single cell imaging in vivo has been a great challenge due to an extremely high sensitive detection of single cell. Recently, there has been great attention for in vivo single cell imaging due to the development of single cell study. In vivo single imaging could analyze the survival or death, movement direction, and characteristics of a single cell in live subjects. In this article, we reviewed basic principle of in vivo molecular imaging and introduced recent studies for in vivo single cell imaging based on the concept of in vivo molecular imaging.

• Journal of radiological science and technology
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• v.45 no.3
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• pp.225-232
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• 2022

Fine dust threatens human health in various forms, depending on the particle size, such as by causing respiratory, cardiovascular, and brain diseases, after entering the body via the lungs. The aim of this study was to correlate fine dust exposure with changes in brain blood flow in Sprague Dawley rats by using micro-positron emission tomography and elucidate the possibility of developing cerebrovascular diseases caused by fine dust. The subjects were exposured to an average fine dust (particulate matter 2.5) of 206.2 ± 7.74 to ten rats four times a day, twice a day for 90 min. Before the experiment, they were maintained at NPO to the maximize the intake of ¹⁸F-fluorodeoxy glucose(¹⁸F-FDG) and minimize changes in the ¹⁸F-FDG biomass depending on the ambient environment and body temperature of the rats. PET images were acquired in the list mode 40 min after injecting ¹⁸F-FDG 44.4 MBq into the rats tail vein using a micro-PET scanner pre and post exposure to fine dust. We found that the whole brain level of ¹⁸F-FDG standardized uptake value in rats averaged 5.21 ± 0.52 g/mL pre and 4.22 ± 0.48 g/mL post exposure to fine dust, resulting in a statistically significant difference. Fine dust was able to alter brain activity after entering the body via the lungs in various forms depending on the particle size.

• Journal of Radiopharmaceuticals and Molecular Probes
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• v.9 no.1
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• pp.3-8
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• 2023

Parkinson's disease is a neurodegenerative disease caused by damage to brain neurons related to dopamine. Non-clinical animal models mainly used in Parkinson's disease research include drug-induced models of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and 6-hydroxydopamine, and genetically modified transgenic animal models. Parkinson's diagnosis can be made using brain imaging of the substantia nigra-striatal dopamine system and using a radiotracer that specifically binds to the dopamine transporter. In this study, ¹⁸F-N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane was used to confirm the image evaluation cutoff between normal and parkinson's disease models, and to confirm model persistence over time. In addition, the efficacy of single or combined administration of clinically used therapeutic drugs in parkinson's animal models was evaluated. Image analysis was performed using the PMOD software. Converted to standardized uptake value, and analyzed by standardized uptake value ratio by dividing the average value of left striatum by the average value of right striatum obtained by applying positron emission tomography images to the atlas magnetic resonance template. The image cutoff of the normal and the parkinson's disease model was calculated as SUVR=0.829, and it was confirmed that it was maintained during the test period. In the three-drug combination administration group, the right and left striatum showed a high symmetry of more than 0.942 on average and recovered significantly. Images using ¹⁸F-N-(3-fluoropropyl)-2β-carboxymethoxy-3β-(4-iodophenyl) nortropane are thought to be able to diagnose and evaluate treatment efficacy of non-clinical Parkinson's disease.

• The Journal of Internal Korean Medicine
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• v.44 no.3
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• pp.578-584
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• 2023

Objectives: This is a five-year survival and complete response (CR) report on rectal cancer treated with western medicine and Korean traditional medicine. Method: A 25-year-old woman diagnosed with rectal cancer visited ⃝⃝ Korean traditional medicine hospital after neoadjuvant concurrent chemoradiation therapy, chemotherapy, and low anterior resection with regional lymph node dissection. She was treated with Korean traditional medicine, including acupuncture, abdominal moxibustion, wild ginseng pharmacopuncture, and herbal medicine, which was based on integrated medicine therapy (IMT), from January 2018 to February 2022. The tumor size was measured by scanning with computed tomography (CT), magnetic resonance imaging, and positron-emission tomography/CT. Adverse events were evaluated using laboratory conclusion and National Cancer Institute Common Terminology Criteria for Adverse Events version 5.0. Result: During four years of treatment, IMT maintained safety. The patient finally reached five-year survival without any recurrence or complication (CR) on March 11, 2022. Conclusion: We suggest that an integrative approach including Korean traditional medicine can be a meaningful treatment option for rectal cancer. Further studies should be performed to establish the proper treatment protocol of integrative medicine for rectal cancer.

• Proceedings of the Korean Society of Computer Information Conference
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• 2023.07a
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• pp.179-181
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• 2023

본 논문에서는 GAN 기반의 영상 생성 방법론을 이용해 delayed PET 영상을 생성하는 연구를 수행하였다. PET은 양전자를 방출하는 방사성 동위원소를 표지한 방사성의약품의 체내 분포를 시각화함으로서 암 세포 진단에 이용되는 의료영상 기법이다. 하지만 PET의 스캔 과정에서 방사성의약품이 체내에 분포하는 데에 걸리는 시간이 오래 걸린다는 문제점이 존재한다. 따라서 본 연구에서는 방사성의약품이 충분히 분포되지 않은 상태에서 얻은 PET 영상을 통해 목표로 하는 충분히 시간이 지난 후에 얻은 PET 영상을 생성하는 모델을 GAN (generative adversarial network)에 기반한 image-to-image translation(I2I)를 통해 수행했다. 특히, 생성 전후의 영상 간의 영상 쌍을 고려한 paired I2I인 Pix2pix와 이를 고려하지 않은 unpaired I2I인 CycleGAN 두 가지의 방법론을 비교하였다. 연구 결과, Pix2pix에 기반해 생성한 delayed PET 영상이 CycleGAN을 통해 생성한 영상에 비해 영상 품질이 좋음을 확인했으며, 또한 실제 획득한 ground-truth delayed PET 영상과의 유사도 또한 더 높음을 확인할 수 있었다. 결과적으로, 딥러닝에 기반해 early PET을 통해 delayed PET을 생성할 수 있었으며, paired I2I를 적용할 경우 보다 높은 성능을 기대할 수 있었다. 이를 통해 PET 영상 획득 과정에서 방사성의약품의 체내 분포에 소요되는 시간을 딥러닝 모델을 통해 줄여 PET 이미징 과정의 시간적 비용을 절감하는 데에 크게 기여할 수 있을 것으로 기대된다.

• Proceedings of the Korean Society of Computer Information Conference
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• 2023.07a
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• pp.63-65
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• 2023

본 논문에서는 FDG-PET 영상을 사용하는 딥러닝 네트워크를 이용하여 직장암 환자의 치료 후 완치를 예측하는 연구를 수행하였다. 직장암은 흔한 악성 종양 중 하나이지만 병리학적으로 완전하게 치료되는 가능성이 매우 낮아, 치료 후의 반응을 예측하고 적절한 치료 방법을 선택하는 것이 중요하다. 따라서 본 연구에서는 FDG-PET 영상에 합성곱 신경망(CNN)모델을 활용하여 딥러닝 네트워크를 구축하고 직장암 환자의 치료반응을 예측하는 연구를 진행하였다. 116명의 직장암 환자의 FDG-PET 영상을 획득하였다. 대상군은 2cm 이상의 종양 크기를 가지는 환자를 대상으로 하였으며 치료 후 완치된 환자는 21명이었다. FDG-PET 영상은 전신 영역과 종양 영역으로 나누어 평가하였다. 딥러닝 네트워크는 2차원 및 3차원 영상입력에 대한 CNN 모델로 구성되었다. 학습된 CNN 모델을 사용하여 직장암의 치료 후 완치를 예측하는 성능을 평가하였다. 학습 결과에서 평균 정확도와 정밀도는 각각 0.854와 0.905로 나타났으며, 모든 CNN 모델과 영상 영역에 따른 성능을 보였다. 테스트 결과에서는 3차원 CNN 모델과 종양 영역만을 이용한 네트워크에서 정확도가 높게 평가됨을 확인하였다. 본 연구에서는 CNN 모델의 입력 영상에 따른 차이와 영상 영역에 따른 딥러닝 네트워크의 성능을 평가하였으며 딥러닝 네트워크 모델을 통해 직장암 치료반응을 예측하고 적절한 치료 방향 결정에 도움이 될 것으로 기대한다.

• Journal of Digestive Cancer Research
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• v.6 no.1
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• pp.40-44
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• 2018

A 77-year-old man presented with abdominal discomfort and was diagnosed as Borrmann type 3 advanced gastric cancer with multiple lymph node metastases. An abdominal computed tomography (CT) and positron emission tomography-computed tomography (PET-CT) showed AGC, clinical stage IIIC (T4aN3M0). We started neo-adjuvant chemotherapy with FOLFOX (5-fluorouracil (5-FU))+Leucovorin+Oxaliplatin). After 3 cycles of FOLFOX chemotherapy, follow-up endoscopy showed remarkable improvement. Primary lesion and metastatic lymph nodes decreased size on follow up computed tomography (CT). The patient underwent radical total gastrectomy with esophagojejunostomy and histopathology revealed no remnant malignant cells at previous primary cancer lesion. The patient has currently completed his 3 cycle of adjuvant chemotherapy without recurrence. After an abdominal CT response assessment, further course of therapy will be decided.

• Clinical Pain
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• v.18 no.1
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• pp.52-57
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• 2019

Spinal accessory neuropathy (SAN) is commonly caused by an iatrogenic procedure, and that caused by tumors is very rare. We present a case of a 49-year-old man suffering from weakness in the right trapezius and sternocleidomastoid muscle. An electrophysiology study confirmed proximal SAN. Fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) revealed a diffuse large B-cell lymphoma compressing the right spinal accessory nerve. Ultrasonography showed definite atrophy on the trapezius and sternocleidomastoid muscles. In addition, post-chemotherapy FDG-PET/CT showed increased FDG uptake in the right upper trapezius, suggestive of denervation. This is the first report of SAN caused by direct compression by a diffuse large B-cell lymphoma, comprehensively assessed by an electrophysiology study, ultrasonography, and FDG-PET/CT.

• Journal of Chest Surgery
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• v.56 no.6
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• pp.420-430
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• 2023

Background: This study provides an update to a landmark 2004 report describing demographics, training, and trends in adherence to thoracic surgery practice standards in Canada. Methods: An updated questionnaire was administered to all members of the Canadian Association of Thoracic Surgeons via email (n=142, compared to n=68 in 2004). Our report incorporates internal data from Ontario Health and the Canadian Partnership Against Cancer. Results: Forty-eight surgeons completed the survey (male, 70.8%; mean±standard deviation age, 50.3±9.3 years). This represents a 33.8% response rate, compared to 64.7% in 2004. Most surgeons (69%) served a patient population of over 1 million per center; 32%-34% reported an on-call ratio of 1:4-1:5 days, and the average weekly hours worked was 56.4±11.9. Greater access to dedicated geographic units per center (73% in 2021 vs. 53% in 2004) has improved thoracic-associated services and house staff, notably endoscopy units (100% vs. 91%), with 73% of respondents having access to both endobronchial and endoscopic ultrasound. Access to thoracic radiology has also improved, particularly regarding positron emission tomography scanners per center (76.9% vs. 13%). Annual case volumes for lung (255 vs. 128), esophageal (41 vs. 19), and mediastinal resections (30 vs. 13), along with hiatal hernia repair (45 vs. 20), have increased substantially despite reports of operating room availability and radiology as rate-limiting steps. Conclusion: This survey characterizes compliance with current practice standards, addressing the needs of thoracic surgeons across Canada. Over 85% of respondents were aware of the 2004 compliance paper, and 35% had applied for resources and equipment in response.