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Lim S, Park YJ, Lee SJ, An YS, Yoon JK. Clinical Feasibility of Deep Learning-Based Attenuation Correction Models for Tl-201 Myocardial Perfusion SPECT. Clin Nucl Med 2024; 49:397-403. [PMID: 38409758 DOI: 10.1097/rlu.0000000000005129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
PURPOSE We aimed to develop deep learning (DL)-based attenuation correction models for Tl-201 myocardial perfusion SPECT (MPS) images and evaluate their clinical feasibility. PATIENTS AND METHODS We conducted a retrospective study of patients with suspected or known coronary artery disease. We proposed a DL-based image-to-image translation technique to transform non-attenuation-corrected images into CT-based attenuation-corrected (CT AC ) images. The model was trained using a modified U-Net with structural similarity index (SSIM) loss and mean squared error (MSE) loss and compared with other models. Segment-wise analysis using a polar map and visual assessment for the generated attenuation-corrected (GEN AC ) images were also performed to evaluate clinical feasibility. RESULTS This study comprised 657 men and 328 women (age, 65 ± 11 years). Among the various models, the modified U-Net achieved the highest performance with an average mean absolute error of 0.003, an SSIM of 0.990, and a peak signal-to-noise ratio of 33.658. The performance of the model was not different between the stress and rest datasets. In the segment-wise analysis, the myocardial perfusion of the inferior wall was significantly higher in GEN AC images than in the non-attenuation-corrected images in both the rest and stress test sets ( P < 0.05). In the visual assessment of patients with diaphragmatic attenuation, scores of 4 (similar to CT AC images) or 5 (indistinguishable from CT AC images) were assigned to most GEN AC images (65/68). CONCLUSIONS Our clinically feasible DL-based attenuation correction models can replace the CT-based method in Tl-201 MPS, and it would be useful in case SPECT/CT is unavailable for MPS.
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Affiliation(s)
- Sungjoo Lim
- From the Department of Biomedical Systems Informatics, Yonsei University, Seoul
| | - Yong-Jin Park
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
| | - Su Jin Lee
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
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Goldberg DJ, Hu C, Lubert AM, Rathod RH, Penny DJ, Petit CJ, Schumacher KR, Ginde S, Williams RV, Yoon JK, Kim GB, Nowlen TT, DiMaria MV, Frischhertz BP, Wagner JB, McHugh KE, McCrindle BW, Cartoski MJ, Detterich JA, Yetman AT, John AS, Richmond ME, Yung D, Payne RM, Mackie AS, Davis CK, Shahanavaz S, Hill KD, Almaguer M, Zak V, McBride MG, Goldstein BH, Pearson GD, Paridon SM. The Fontan Udenafil Exercise Longitudinal Trial: Subgroup Analysis. Pediatr Cardiol 2023; 44:1691-1701. [PMID: 37382636 DOI: 10.1007/s00246-023-03204-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 05/31/2023] [Indexed: 06/30/2023]
Abstract
The Pediatric Heart Network's Fontan Udenafil Exercise Longitudinal (FUEL) Trial (Mezzion Pharma Co. Ltd., NCT02741115) demonstrated improvements in some measures of exercise capacity and in the myocardial performance index following 6 months of treatment with udenafil (87.5 mg twice daily). In this post hoc analysis, we evaluate whether subgroups within the population experienced a differential effect on exercise performance in response to treatment. The effect of udenafil on exercise was evaluated within subgroups defined by baseline characteristics, including peak oxygen consumption (VO2), serum brain-type natriuretic peptide level, weight, race, gender, and ventricular morphology. Differences among subgroups were evaluated using ANCOVA modeling with fixed factors for treatment arm and subgroup and the interaction between treatment arm and subgroup. Within-subgroup analyses demonstrated trends toward quantitative improvements in peak VO2, work rate at the ventilatory anaerobic threshold (VAT), VO2 at VAT, and ventilatory efficiency (VE/VCO2) for those randomized to udenafil compared to placebo in nearly all subgroups. There was no identified differential response to udenafil based on baseline peak VO2, baseline BNP level, weight, race and ethnicity, gender, or ventricular morphology, although participants in the lowest tertile of baseline peak VO2 trended toward larger improvements. The absence of a differential response across subgroups in response to treatment with udenafil suggests that the treatment benefit may not be restricted to specific sub-populations. Further work is warranted to confirm the potential benefit of udenafil and to evaluate the long-term tolerability and safety of treatment and to determine the impact of udenafil on the development of other morbidities related to the Fontan circulation.Trial Registration NCT0274115.
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Affiliation(s)
- David J Goldberg
- Division of Cardiology, The Children's Hospital of Philadelphia, Perelman School of Medicine, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA.
| | | | - Adam M Lubert
- Cincinnati Children's Hospital and Medical Center, Heart Institute, Cincinnati, OH, 45229, USA
| | - Rahul H Rathod
- Department of Cardiology, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, MA, 02115, USA
| | - Daniel J Penny
- Division of Cardiology, Texas Children's Hospital, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Christopher J Petit
- Division of Pediatric Cardiology, Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY, 10032, USA
| | - Kurt R Schumacher
- Division of Cardiology, C.S. Mott Children's Hospital, Ann Arbor, MI, 48109, USA
| | - Salil Ginde
- Division of Cardiology, Medical College of Wisconsin, Children's Hospital of Wisconsin, Milwaukee, WI, 53226, USA
| | - Richard V Williams
- Division of Pediatric Cardiology, University of Utah, Primary Children's Hospital, Salt Lake City, UT, 84132, USA
| | - J K Yoon
- Department of Pediatrics, Sejong General Hospital, Bucheon, South Korea
| | - Gi Beom Kim
- Seoul National University School of Medicine, Seoul National University Children's Hospital, Seoul, South Korea
| | - Todd T Nowlen
- Heart Center, Phoenix Children's Hospital, Phoenix, AZ, 85016, USA
| | - Michael V DiMaria
- Department of Pediatrics, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, CO, 80045, USA
| | - Benjamin P Frischhertz
- Division of Cardiology, Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Jonathan B Wagner
- Divisions of Cardiology and Clinical Pharmacology, Children's Mercy Kansas City, Kansas City, MO, 64108, USA
| | - Kimberly E McHugh
- Division of Pediatric Cardiology, Medical University of South Carolina, Charleston, SC, 29425, USA
| | - Brian W McCrindle
- Department of Pediatrics, The Labatt Family Heart Centre, The Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
| | - Mark J Cartoski
- Nemours Cardiac Center, Nemours / Alfred I. DuPont Hospital for Children, Wilmington, DE, 19803, USA
| | - Jon A Detterich
- Division of Cardiology, Children's Hospital Los Angeles, USC Keck School of Medicine, Los Angeles, CA, 90027, USA
| | - Anji T Yetman
- Children's Hospital and Medical Center, University of Nebraska, Omaha, NE, 68114, USA
| | - Anitha S John
- Division of Cardiology, Children's National Hospital, Washington, DC, 20010, USA
| | - Marc E Richmond
- Division of Pediatric Cardiology, Morgan Stanley Children's Hospital, Columbia University Medical Center, New York, NY, 10032, USA
| | - Delphine Yung
- Division of Pediatric Cardiology, University of Washington School of Medicine, Seattle Children's Hospital, Seattle, WA, 98105, USA
| | - R Mark Payne
- Division of Cardiology, Riley Hospital for Children, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Andrew S Mackie
- Division of Cardiology, Stollery Children's Hospital, Edmonton, AB, T6G 2B7, Canada
| | - Christopher K Davis
- Division of Cardiology, Rady Children's Hospital San Diego, University of California San Diego, San Diego, CA, 92123, USA
| | - Shabana Shahanavaz
- Division of Cardiology, St. Louis Children's Hospital, St. Louis, MO, 63110, USA
| | - Kevin D Hill
- Duke Children's Pediatric and Congenital Heart Center, Durham, NC, 27705, USA
| | - Marisa Almaguer
- Cincinnati Children's Hospital and Medical Center, Heart Institute, Cincinnati, OH, 45229, USA
| | | | - Michael G McBride
- Division of Cardiology, The Children's Hospital of Philadelphia, Perelman School of Medicine, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Bryan H Goldstein
- Division of Cardiology, UPMC Children's Hospital of Pittsburgh, Pittsburgh, PA, 15224, USA
| | - Gail D Pearson
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, NIH, Bethesda, MD, 20892, USA
| | - Stephen M Paridon
- Division of Cardiology, The Children's Hospital of Philadelphia, Perelman School of Medicine, 34th Street and Civic Center Blvd, Philadelphia, PA, 19104, USA
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Yoon JK, Kang WJ. Modulation of FDG Uptake by Cell Cycle Synchronization Using a T-Type Calcium Channel Inhibitor. Cancers (Basel) 2023; 15:5244. [PMID: 37958418 PMCID: PMC10650550 DOI: 10.3390/cancers15215244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND We investigated whether cell cycle synchronization induced by the T-type calcium channel inhibitor mibefradil could increase tumoral 2-[18F] fluoro-2-deoxy-d-glucose (FDG) uptake in vitro and in vivo. METHODS Human prostate cancer cells (PC-3) were treated with 10 μM mibefradil for 24, 48, and 72 h to induce G1 arrest. Cell cycle distribution was analyzed at 0, 4, 8, 12, 15, 18, and 24 h after mibefradil withdrawal. Cellular uptake was measured after incubating cells with [3H] Deoxy-d-Glucose (DDG) for 1 h at the same time points used in the cell cycle analysis. The correlation between [3H] DDG uptake and each cell cycle phase was evaluated in the early (0-12 h) and late phases (15-24 h) of synchronization. In vivo FDG PET imaging was performed in PC-3-bearing mice at baseline, 24 h, and 48 h after mibefradil treatment. RESULTS The G0/G1 fraction of PC-3 cells was significantly increased from 33.1% ± 0.2% to 60.9% ± 0.8% after 24 h mibefradil treatment, whereas the S and G2/M fractions were decreased from 36.3% ± 1.4% to 23.2% ± 1.1% and from 29.7% ± 1.3% to 14.9% ± 0.9%, respectively, which were similar to the results by serum starvation. Mibefradil treatment for 24, 48, and 72 h increased the number of cells in S phase at 18-24 h after withdrawal; however, only the 72 h treatment increased [3H] DDG uptake (145.8 ± 5.8% of control at 24 h after withdrawal). [3H] DDG uptake was positively correlated with the size of the S phase fraction and negatively correlated with the size of the G0/G1 fraction in the late phase of synchronization. DDG uptake was significantly increased by mibefradil-induced cell cycle synchronization and correlated with the sizes of cell cycle fractions. In vivo FDG PET imaging also demonstrated a significant increase in tumor uptake after mibefradil treatment. Quantified tumor FDG uptake (%ID/g) increased from 4.13 ± 2.10 to 4.7 ± 2.16 at 24 h, and 5.95 ± 2.57 at 48 h (p < 0.05). CONCLUSION Cell cycle synchronization could be used to increase the diagnostic sensitivity of clinical FDG positron emission tomography.
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Affiliation(s)
- Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon 16499, Republic of Korea;
| | - Won Jun Kang
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
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An YS, Lee J, Kim HK, Lee SJ, Yoon JK. Effect of withdrawal of thyroid hormones versus administration of recombinant human thyroid-stimulating hormone on renal function in thyroid cancer patients. Sci Rep 2023; 13:206. [PMID: 36604466 PMCID: PMC9814098 DOI: 10.1038/s41598-023-27455-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 01/02/2023] [Indexed: 01/06/2023] Open
Abstract
This study was conducted to investigate the effects of thyroid hormone withdrawal (THW) and recombinant human thyroid-stimulating hormone (rhTSH) administration on renal function in patients with thyroid cancer after total thyroidectomy. This study included 202 patients who discontinued thyroid hormone therapy and/or received rhTSH after total thyroidectomy. Creatinine (Cr), blood urea nitrogen (BUN) levels, and estimated glomerular filtration rate (eGFR) were assessed at the following three time points: before thyroidectomy, at least 3 weeks after THW, and 1 day after the second injection of rhTSH. The median serum Cr level was significantly higher following THW compared to that before thyroidectomy (0.95 versus 0.70). In contrast, the median BUN level was significantly lower after THW compared to that before thyroidectomy (9.8 versus 11.3). Over a fifth (22.2%) of patients had abnormal eGFR values after THW, which was significantly greater than that before thyroidectomy. In contrast, renal parameter values after rhTSH administration were not significantly different than those before thyroidectomy. In conclusion, THW affects renal function in patients with thyroid cancer who have undergone total thyroidectomy. However, renal function in such patients is not affected by rhTSH administration.
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Affiliation(s)
- Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea.
| | - Jeonghun Lee
- grid.251916.80000 0004 0532 3933Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Hyeung Kyoo Kim
- grid.251916.80000 0004 0532 3933Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Su Jin Lee
- grid.251916.80000 0004 0532 3933Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
| | - Joon-Kee Yoon
- grid.251916.80000 0004 0532 3933Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
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Jung JY, Yoon JK, Lee SJ, An YS. Sublingual Gland Observed on Salivary Gland Scan. Clin Nucl Med 2022; 47:876-877. [PMID: 35307724 DOI: 10.1097/rlu.0000000000004183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The major salivary glands, namely, the parotid, submandibular, and sublingual glands, are important in maintaining oral cavity health. A salivary gland scan is used to evaluate the uptake and excretory function of the salivary glands. By intravenously injecting 99m TcO 4- , which is distributed like chloride ions in the body, the glands become visible on the salivary gland scan. The parotid and submandibular glands are typically appreciated on the salivary gland scan, but the sublingual gland is not. We present a rare image of a prominent sublingual gland on a salivary gland scan.
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Affiliation(s)
| | - Joon-Kee Yoon
- Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
| | - Su Jin Lee
- Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
| | - Young-Sil An
- Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
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Kim IH, Lee SJ, An YS, Choi SY, Yoon JK. Simulating dose reduction for myocardial perfusion SPECT using a Poisson resampling method. Nucl Med Mol Imaging 2021; 55:245-252. [PMID: 34721717 DOI: 10.1007/s13139-021-00710-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 07/23/2021] [Accepted: 07/28/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose The purpose of this study was to determine the lowest Tl-201 dose that does not reduce the image quality of myocardial perfusion SPECT (MPS) by Poisson resampling simulation. Methods One hundred and twelve consecutive MPS data from patients with suspected or known coronary artery disease were collected retrospectively. Stress and rest MPS data were resampled using the Poisson method with 33%, 50%, 67%, and 100% count settings. Two nuclear medicine physicians assessed the image quality of reconstructed data visually by giving grades from - 2 to + 2. The summed stress score (SSS), summed rest score (SRS), and summed difference score (SDS) were obtained on the workstation. Image quality grades and semi-quantitative scores were then compared among these resampled images. Results The proportions of "adequate" image quality were 0.48, 0.75, 0.92, and 0.96 for the groups of images with 33%, 50%, 67%, and 100% data, respectively. The quality of the resampled images was significantly degraded at 50% and 33% count settings, while the image quality was not different between 67 and 100% count settings. We also found that high body mass index further decreased image quality at 33% count setting. Among the semi-quantitative parameters, SSS and SRS showed a tendency to increase with a decline in count. Conclusion Based on the simulation results, Tl-201 dose for MPS can be reduced to 74 MBq without significant loss of image quality. However, the SSS and SRS can be changed significantly, and it needs to be further verified under the different conditions.
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Affiliation(s)
- Il-Hyun Kim
- Departments of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 16499
| | - Su Jin Lee
- Departments of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 16499
| | - Young-Sil An
- Departments of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 16499
| | - So-Yeon Choi
- Department of Cardiology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Joon-Kee Yoon
- Departments of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 16499
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Hwang JP, Moon JH, Kim HK, Lee MH, Lim CH, Park SB, Yoon JK, Park JM. Prognostic value of metabolic parameters measured by pretreatment dual-time-point 18F-fluorodeoxyglucose positron emission tomography/computed tomography in patients with intrahepatic or perihilar cholangiocarcinoma: A STROBE study. Medicine (Baltimore) 2021; 100:e26015. [PMID: 34032720 PMCID: PMC8154415 DOI: 10.1097/md.0000000000026015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Accepted: 04/30/2021] [Indexed: 01/04/2023] Open
Abstract
The purpose of this study was to determine the glucose metabolism at delay phase measured by pretreatment dual-time-point 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/ computed tomography (CT) provides prognostic information independent of well-known prognostic factors in patients with intrahepatic or perihilar cholangiocarcinoma (ICC or PCC).From July 2012 to December 2017, 55 patients (men 27, women 28, mean age 68 ± 11 years) with pathologically proven ICC or PCC were enrolled in this retrospective study. The dual-time-point 18F-FDG PET/CT as part of a staging workup was performed in all patients. The patient's data includes age, sex, serum CA19-9, presence of LN or distant metastasis, early SUVmax (early maximum standardized uptake value [eSUV]), delay SUVmax (delay maximum standardized uptake value [dSUV]), retention index of SUVmax (percent change of maximum standardized uptake values [ΔSUV]), neutrophil to lymphocyte ratio (NLR) and histopathology including pCEA, p53, Ki-67 index. The analysis of the relationship between metabolic parameters and survival was done using the Kaplan-Meier curve and Cox proportional hazards regression model.Median survival for all patients was 357 days. Median early and delay SUVmax was 5.2 (range: 2.0-21.4) and 6.5 (range 2.7-24.5), respectively. The overall survival was found to be significantly related to eSUV, dSUV, ΔSUV, age, serum CA19-9 and NLR in univariate analysis. In multivariate analysis, dSUV (P = .014, 95%CI; 1.30-10.7, HR 3.74) and ΔSUVmax (P = .037, 95%CI; 1.05-6.12, HR 2.5) were independent factors of overall survival. Kaplan-Meier curve analysis clearly showed the significant difference of overall survival between 2 groups (high eSUV, low eSUV + high ΔSUV vs low eSUV and ΔSUV, P < .001) among the comparisons of the SUV parameters on FDG PET. In the receiver operating characteristic analysis using combinations of the SUV parameters, the 2 groups [eSUV + ΔSUV (P = .0001, area under the curve [AUC] 0.68) and dSUV + ΔSUV (P = .0002, AUC 0.71)] showed significantly larger AUC than the other groups applying eSUV or dSUV alone (AUC 0.61 and AUC 0.68).dSUV and ΔSUV on pretreatment dual-time-point 18F-FDG PET/CT can be useful parameters in the prediction of survival in patients with ICC or PCC.
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Affiliation(s)
| | | | | | - Min Hee Lee
- Departments of Radiology, Soonchunhyang University Hospital Bucheon, Bucheon
| | - Chae Hong Lim
- Departments of Nuclear Medicine, Soonchunhyang University Hospital Seoul, Seoul
| | - Soo Bin Park
- Departments of Nuclear Medicine, Soonchunhyang University Hospital Seoul, Seoul
| | - Joon-Kee Yoon
- Department of Nuclear Medicine, Ajou University Medical Center, Suwon, Republic of Korea
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An YS, Park DY, Min BH, Lee SJ, Yoon JK. Comparison of bone single-photon emission computed tomography (SPECT)/CT and bone scintigraphy in assessing knee joints. BMC Med Imaging 2021; 21:60. [PMID: 33771130 PMCID: PMC8004469 DOI: 10.1186/s12880-021-00590-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study attempted to compare the radiopharmaceutical uptake findings of planar bone scintigraphy (BS) and single photon emission computed tomography (SPECT)/computed tomography (CT) performed on knee joints. METHODS We retrospectively included 104 patients who underwent bone SPECT/CT and BS 4 h after the intravenous administration of technetium-99m-hydroxymethylene diphosphonate (99mTc-HDP) for pain in the knee joint. The uptake degree of each of the knee regions (medial femoral, lateral femoral, medial tibial, lateral tibial, and patellar area) in planar images and SPECT/CT were evaluated by visual (grades 0 to 2) and quantitative analyses (uptake counts for planar image and standardized uptake values [SUVs] for SPECT/CT). RESULTS The uptake grades assessed visually on the planar images differed significantly from the uptake grades on SPECT/CT images in all areas of the knee (all p < 0.001), and SPECT/CT imaging revealed a larger number of uptake lesions than those noted in planar imaging for each patient (3.3 ± 2.0 vs 2.4 ± 2.3, p < 0.0001). In all regions of the knee, all of the quantitative values, including uptake counts obtained from the planar image as well as the maximum SUV (SUVmax) and mean SUV (SUVmean) obtained from SPECT/CT, showed statistically higher values as their visual grades increased (all p < 0.001). However, when analyzed for each area, only the SUVmax showed a significant difference by grade in all knee regions. Quantitative uptake values obtained from planar images were moderately correlated with SUVs of SPECT/CT images (r = 0.58 for SUVmean and r = 0.53 for SUVmax, all p < 0.001) in the total knee regions. Looking at each area, there was a significant but low correlation between the uptake counts of the planar images and the SUVs on SPECT/CT in the right lateral tibial region (r = 0.45 for SUVmean, r = 0.31 for SUVmax, all p < 0.001). CONCLUSIONS In assessing knee joints, the findings of planar images and SPECT/CT images differ both visually and quantitatively, and more lesions can be found in SPECT/CT than in the planar images. The SUVmax could be a reliable value to evaluate knee joint uptake activity.
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Affiliation(s)
- Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University, 206, World cup-ro, Yeongtong-gu, Suwon-si, Suwon, Gyeonggi-do, 16499, Korea.
| | - Do Young Park
- Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Byoung-Hyun Min
- Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Su Jin Lee
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University, 206, World cup-ro, Yeongtong-gu, Suwon-si, Suwon, Gyeonggi-do, 16499, Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University, 206, World cup-ro, Yeongtong-gu, Suwon-si, Suwon, Gyeonggi-do, 16499, Korea
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Kim IH, An YS, Lee SJ, Hong J, Yoon JK. Hilar Choledochal Cyst Mimicking Biliary Atresia on Hepatobiliary Scintigraphy: a Case Report. Nucl Med Mol Imaging 2021; 55:96-99. [PMID: 33968276 DOI: 10.1007/s13139-021-00688-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/15/2021] [Accepted: 01/18/2021] [Indexed: 11/29/2022] Open
Abstract
Hepatobiliary scintigraphy has been widely used for the differential diagnosis of neonatal cholestasis. Relatively good hepatic uptake with no evidence of excretion into the bowel for up to 24 h is a representative finding of biliary atresia. Hepatobiliary scintigraphy has very high sensitivity and moderate specificity. Here, we report a false-positive case of hepatobiliary scintigraphy in a child with a choledochal cyst, which mimicked biliary atresia.
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Affiliation(s)
- Il-Hyun Kim
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Worldcup-ro 164, Suwon, Kyunggi-do 16499 Republic of Korea
| | - Young-Sil An
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Worldcup-ro 164, Suwon, Kyunggi-do 16499 Republic of Korea
| | - Su Jin Lee
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Worldcup-ro 164, Suwon, Kyunggi-do 16499 Republic of Korea
| | - Jeong Hong
- Department of Surgery, Ajou University School of Medicine, Worldcup-ro 164, Suwon, Kyunggi-do 16499 Republic of Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Worldcup-ro 164, Suwon, Kyunggi-do 16499 Republic of Korea
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Chong A, Park JM, Pak K, Kim YI, Kwon HW, Lee ES, Nam KP, Lee HY, Lee HJ, Yoo ID, Eo JS, Kim JY, Yoon JK, Kim KM, Kim SM, Kim TS. Recent Survey of Effective Doses of F-18 FDG Torso PET/CT in Korea and the Current Recommendations for CT Protocols of PET/CT. Nucl Med Mol Imaging 2020; 54:224-232. [PMID: 33088351 DOI: 10.1007/s13139-020-00654-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 06/04/2020] [Accepted: 07/10/2020] [Indexed: 11/29/2022] Open
Abstract
Purpose This study aimed to construct a database of the effective doses (ED) from F-18 fluorodeoxyglucose (FDG) torso positron emission tomography/computed tomography (PET/CT) in Korea to provide data that supports the reduction of the CT dose of PET/CT and optimization of PET/CT protocols in Korea. Methods We investigated data of ED and CT parameters of FDG PET/CT. The data were analyzed by body weight groups. Results A total of 31 hospitals participated in the survey (99 adults). The mean total EDs (± SD) were 8.77 ± 2.76, 10.93 ± 3.14, and 12.57 ± 3.79 mSv for the 55-, 70-, and 85-kg groups, respectively. The FDG EDs were 4.80 ± 0.98, 6.05 ± 1.15, and 6.89 ± 1.52 mSv, and the CT EDs were 4.00 ± 2.12, 4.88 ± 2.51, and 5.68 ± 2.89 mSv, respectively. Of the enrolled hospitals, 54.5% used ultra-low-dose CT protocols, and their CT ED was significantly lower than low-dose CT group in all groups (2.9 ± 1.0, 3.2 ± 1.1, and 3.3 ± 1.0 mSv vs. 6.6 ± 1.6, 7.2 ± 2.1, and 7.9 ± 2.2 mSv, all p < 0.001, respectively). In the ultra-low-dose CT group, the CT ED with the iterative reconstruction was significantly lower than that of CT without iterative reconstruction in the 55-kg group (2.4 ± 0.9 vs. 3.3 ± 0.9, p = 0.04). Conclusions These results and current recommendations can be helpful for optimizing PET/CT diagnostic reference level (DRL) and reducing unnecessary PET/CT radiation exposure.
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Affiliation(s)
- Ari Chong
- Department of Nuclear Medicine, Chosun University Hospital, Gwangju, South Korea
| | - Jung Mi Park
- Department of Nuclear Medicine, Soonchunhyang University Bucheon Hospital, Bucheon-si, Gyeonggi-do Republic of Korea
| | - Kyoungjune Pak
- Department of Nuclear Medicine, Pusan National University Hospital, Busan, South Korea
| | - Yong-Il Kim
- Department of Nuclear Medicine, Asan Medical Center, Seoul, South Korea
| | - Hyun Woo Kwon
- Department of Nuclear Medicine, Korea University Anam Hospital, Seoul, South Korea
| | - Eun Seong Lee
- Department of Nuclear Medicine, Korea University Medical Center, Korea University College of Medicine, Seoul, South Korea
| | - Ki Pyo Nam
- Department of Nuclear Medicine, Asan Medical Center, Seoul, South Korea
| | - Ho-Young Lee
- Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Hong Jae Lee
- Department of Nuclear Medicine, Seoul National University Hospital, Seoul, Republic of Korea
| | - Ik Dong Yoo
- Department of Nuclear Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, South Korea
| | - Jae Seon Eo
- Department of Nuclear Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Ji Young Kim
- Department of Nuclear Medicine, Hanyang University Guri Hospital, Guri-si, South Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine, Ajou University Medical Center, Suwon, South Korea
| | - Kyeong Min Kim
- Division of Applied RI, Korea Institute of Radiological and Medical Sciences, Seoul, South Korea
| | - Seong Min Kim
- Department of Nuclear Medicine, Chungnam National University Hospital, Daejeon, South Korea
| | - Tae-Sung Kim
- Department of Nuclear Medicine, National Cancer Center, Goyang-si, South Korea
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Park BN, Kim JH, Lim TS, Park SH, Kim TG, Yoon BS, Son KS, Yoon JK, An YS. Therapeutic effect of mesenchymal stem cells in an animal model of Alzheimer's disease evaluated by β-amyloid positron emission tomography imaging. Aust N Z J Psychiatry 2020; 54:883-891. [PMID: 32436738 DOI: 10.1177/0004867420917467] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE We evaluated the effects of bone marrow-derived mesenchymal stem cells in a model of Alzheimer's disease using serial [18F]Florbetaben positron emission tomography. METHODS 3xTg Alzheimer's disease mice were treated with intravenously injected bone marrow-derived mesenchymal stem cells, and animals without stem cell therapy were used as controls. Serial [18F]Florbetaben positron emission tomography was performed after therapy. The standardized uptake value ratio was measured as the cortex standardized uptake value divided by the cerebellum standardized uptake value. Memory function and histological changes were observed using the Barnes maze test and β-amyloid-reactive cells. RESULTS Standardized uptake value ratio decreased significantly from day 14 after stem cell administration in the bone marrow-derived mesenchymal stem cells-treated group (n = 28). In contrast, there was no change in the ratio in control mice (n = 25) at any time point. In addition, mice that received bone marrow-derived mesenchymal stem cell therapy also exhibited significantly better memory function and less β-amyloid-immunopositive plaques compared to controls. CONCLUSION The therapeutic effect of intravenously injected bone marrow-derived mesenchymal stem cells in a mouse model of Alzheimer's disease was confirmed by β-amyloid positron emission tomography imaging, memory functional studies and histopathological evaluation.
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Affiliation(s)
- Bok-Nam Park
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University, Suwon, South Korea
| | - Jang-Hee Kim
- Department of Pathology, School of Medicine, Ajou University, Suwon, South Korea
| | - Tae Sung Lim
- Department of Neurology, School of Medicine, Ajou University, Suwon, South Korea
| | - So Hyun Park
- Department of Pathology, School of Medicine, Ajou University, Suwon, South Korea
| | - Tae-Gyu Kim
- Department of Pathology, School of Medicine, Ajou University, Suwon, South Korea
| | - Bok Seon Yoon
- Neuroscience Graduate Program, Biomedical Sciences, School of Medicine, Ajou University, Suwon, South Korea
| | - Keoung Sun Son
- Neuroscience Graduate Program, Biomedical Sciences, School of Medicine, Ajou University, Suwon, South Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University, Suwon, South Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University, Suwon, South Korea
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Hu XG, Shen XY, Nan JN, Kim IG, Yoon JK, Hong SY, Kim MN, Kim BW, Wang HJ. 18F-fluorodeoxyglucose PET/CT as an independent predictor for patients with hepatocellular carcinoma combined with major portal vein tumor thrombus. Ann Surg Treat Res 2020; 99:8-17. [PMID: 32676477 PMCID: PMC7332322 DOI: 10.4174/astr.2020.99.1.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 03/07/2020] [Accepted: 04/07/2020] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Hepatocellular carcinoma (HCC) patients with major portal vein tumor thrombosis (mPVTT) complications were generally characterized by extremely poor prognoses. The aim of this study was to explore the role of 18F-fluorodeoxyglucose (18F-FDG) PET/CT imaging in predicting HCC complicated by mPVTT. METHODS Five hundred one HCC patients received surgery in our hospital during November 2008 to December 2014, among which 32 patients (6.4%) were diagnosed as HCC complicated by mPVTT. Six cases were excluded for reasons of complex medical conditions, including 2 cases of salvage liver transplantation, 2 cases of re-resection, 1 case of mPVTT combined with inferior vina cava tumor thrombosis, and 1 case of residual portal vein tumor thrombosis. Ultimately, 26 cases were enrolled in this study. The maximal tumor standardized uptake value (SUVmax) was identified as a predictive factor and detected. The univariate and multivariate regression analyses were performed to identify the prognostic factors for recurrence-free survival (RFS) and overall survival (OS) of HCC patients complicated by mPVTT. RESULTS Our results showed that the median OS was 16 months. The 1-, 3-, and 5-year cumulative OS was 55.6%, 31.7%, and 31.7%, respectively. The multivariate regression analysis revealed that SUVmax ≥ 4.65 was the only independent risk factor for RFS and OS. CONCLUSION SUVmax was an independent predictor for RFS and OS of patients suffering from both HCC and mPVTT. L ow SUVmax could serve as an effective factor for selecting candidates with low recurrence risks and for helping with improving patient survival after surgical resection.
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Affiliation(s)
- Xu-Guang Hu
- Division of Hepatobiliary Surgery and Intervention, Department of Surgery, Jiangxi Cancer Hospital, Nan Chang, China
| | - Xue-Yin Shen
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Jin-Niang Nan
- Department of Clinical Medicine, Jiangxi Health Career College of China, Nan Chang, China
| | - In-Gyu Kim
- Health Insurance Review and Assessment Service, Seoul, Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
| | - Sung-Yeon Hong
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Mi-Na Kim
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Bong-Wan Kim
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Hee-Jung Wang
- Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Ajou University School of Medicine, Suwon, Korea
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Abstract
89Zr is an emerging radionuclide that plays an essential role in immuno-positron emission tomography (PET) imaging. The long half-life of 89Zr (t1/2 = 3.3 days) is favorable for evaluating the in vivo distribution of monoclonal antibodies. Thus, the use of 89Zr is promising for monitoring antibody-based cancer therapies. Immuno-PET combines the sensitivity of PET with the specificity of antibodies. A number of studies have been conducted to investigate the feasibility of 89Zr immuno-PET imaging for predicting the efficacy of radioimmunotherapy and antibody therapies, imaging target expression, detecting target-expressing tumors, and the monitoring of anti-cancer chemotherapies. In this review, we summarize the current status of PET imaging using 89Zr in both preclinical and clinical studies by highlighting the use of immuno-PET for the targets of high clinical relevance. We also present 89Zr-PET applications other than immuno-PET, such as nanoparticle imaging and cell tracking. Finally, we discuss the limitations and the ongoing research being performed to overcome the remaining hurdles.
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Affiliation(s)
- Joon-Kee Yoon
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Worldcup-ro 164, Suwon 16499, Korea; (B.-N.P.); (Y.-S.A.); (S.-J.L.)
- Correspondence: ; Tel.: +82-31-219-4303
| | - Bok-Nam Park
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Worldcup-ro 164, Suwon 16499, Korea; (B.-N.P.); (Y.-S.A.); (S.-J.L.)
| | - Eun-Kyoung Ryu
- Division of Magnetic Resonance, Korea Basic Science Institute, 162, Yeongudanji-ro, Cheongju 28119, Korea;
| | - Young-Sil An
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Worldcup-ro 164, Suwon 16499, Korea; (B.-N.P.); (Y.-S.A.); (S.-J.L.)
| | - Su-Jin Lee
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Worldcup-ro 164, Suwon 16499, Korea; (B.-N.P.); (Y.-S.A.); (S.-J.L.)
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Kwon SY, Lee SW, Kong EJ, Kim K, Kim BI, Kim J, Kim H, Park SH, Park J, Park HL, Oh SW, Won KS, Ryu YH, Yoon JK, Lee SJ, Lee JJ, Chong A, Jeong YJ, Jeong JH, Cho YS, Cho A, Cheon GJ, Choi EK, Hwang JP, Bae SK. Clinicopathologic risk factors of radioactive iodine therapy based on response assessment in patients with differentiated thyroid cancer: a multicenter retrospective cohort study. Eur J Nucl Med Mol Imaging 2019; 47:561-571. [PMID: 31820047 DOI: 10.1007/s00259-019-04634-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 11/19/2019] [Indexed: 11/26/2022]
Abstract
PURPOSE We investigated whether predictive clinicopathologic factors can be affected by different response criteria and how the clinical usefulness of radioactive iodine (RAI) therapy should be evaluated considering variable factors in patients with differentiated thyroid carcinoma (DTC). METHODS A total of 1563 patients with DTC who underwent first RAI therapy after total or near total thyroidectomy were retrospectively enrolled from 25 hospitals. Response to therapy was evaluated with two different protocols based on combination of biochemical and imaging studies: (1) serum thyroglobulin (Tg) and neck ultrasonography (US) and (2) serum Tg, neck US, and radioiodine scan. The responses to therapy were classified into excellent and non-excellent or acceptable and non-acceptable to minimize the effect of non-specific imaging findings. We investigated which factors were associated with response to therapy depending on the follow-up protocols as well as response classifications. Multivariate logistic regression analysis was performed to identify factors significantly predicting response to therapy. RESULTS The proportion of patients in the excellent response group significantly decreased from 76.5 to 59.6% when radioiodine scan was added to the follow-up protocol (P < 0.001). Preparation method (recombinant human TSH vs. thyroid hormone withdrawal) was a significant factor for excellent response prediction evaluated with radioiodine scan (OR 2.129; 95% CI 1.687-2.685; P < 0.001) but was not for other types of response classifications. Administered RAI activity, which was classified as low (1.11 GBq) or high (3.7 GBq or higher), significantly predicted both excellent and acceptable responses regardless of the follow-up protocol. CONCLUSIONS The clinical impact of factors related to response prediction differed depending on the follow-up protocol or classification of response criteria. A high administered activity of RAI was a significant factor predicting a favorable response to therapy regardless of the follow-up protocol or classification of response criteria.
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Affiliation(s)
- Seong Young Kwon
- Department of Nuclear Medicine, Chonnam National University Medical School and Hwasun Hospital, Hwasun, Jeonnam, Republic of Korea
| | - Sang-Woo Lee
- Department of Nuclear Medicine, School of Medicine and Chilgok Hospital, Kyungpook National University, Daegu, Republic of Korea
| | - Eun Jung Kong
- Department of Nuclear Medicine, Yeungnam University Medical School and Hospital, Daegu, Republic of Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University, Busan, Republic of Korea
| | - Byung Il Kim
- Department of Nuclear Medicine, Korea Institute of Radiological & Medical Sciences, Seoul, Republic of Korea
| | - Jahae Kim
- Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea
| | - Heeyoung Kim
- Department of Nuclear Medicine, Kosin University Gospel Hospital, Busan, Republic of Korea
| | - Seol Hoon Park
- Department of Nuclear Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Republic of Korea
| | - Jisun Park
- Department of Nuclear Medicine, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Hye Lim Park
- Division of Nuclear Medicine, Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - So Won Oh
- Department of Nuclear Medicine, Seoul National University Boramae Medical Center, Seoul, Republic of Korea
| | - Kyoung Sook Won
- Department of Nuclear Medicine, Keimyung University Dongsan Hospital, Daegu, Republic of Korea
| | - Young Hoon Ryu
- Department of Nuclear Medicine, Yonsei University Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Soo Jin Lee
- Department of Nuclear Medicine, Hanyang University Medical Center, Seoul, Republic of Korea
| | - Jong Jin Lee
- Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Ari Chong
- Department of Nuclear Medicine, Chosun University Hospital, Gwangju, Republic of Korea
| | - Young Jin Jeong
- Department of Nuclear Medicine, Dong-A University Hospital, Busan, Republic of Korea
| | - Ju Hye Jeong
- Department of Nuclear Medicine, Kyungpook National University Hospital, Daegu, Republic of Korea
| | - Young Seok Cho
- Department of Nuclear Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Arthur Cho
- Department of Nuclear Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Gi Jeong Cheon
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Eun Kyoung Choi
- Division of Nuclear Medicine, Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jae Pil Hwang
- Department of Nuclear Medicine, Soon Chun Hyang University Bucheon Hospital, Bucheon, Republic of Korea
| | - Sang Kyun Bae
- Department of Nuclear Medicine, Inje University Haeundae Paik Hospital, Busan, Republic of Korea.
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Jeong E, Yoon JK, Lee SJ, Soh EY, Lee J, Kim HK, An YS. Can the basal serum thyroglobulin level be used to predict the recombinant human TSH-stimulated thyroglobulin level in differentiated patients with thyroid cancer? Medicine (Baltimore) 2019; 98:e18437. [PMID: 31861014 PMCID: PMC6940117 DOI: 10.1097/md.0000000000018437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study investigated the correlation between basal thyroglobulin (Tg) and recombinant human thyroid-stimulating hormone (rhTSH)-stimulated Tg in differentiated patients with thyroid cancer, and sought to determine whether the basal Tg level predicts the rhTSH-stimulated Tg level.We retrospectively enrolled 177 patients with papillary thyroid cancer (mean age = 44 years; 50 males, 127 females) who received rhTSH before radioiodine therapy (RIT). Serum Tg levels were measured 7 days before the 1st rhTSH injection (basal Tg) and on the days of RIT (rhTSH-stimulated Tg). Patients were divided into 3 groups according to rhTSH-stimulated Tg cut-off levels of 2, 5, and 10 ng/mL. The correlation between basal Tg and rhTSH-stimulated Tg levels was assessed, and whether basal Tg was useful in predicting the rhTSH-stimulated Tg level was determined.A significant positive correlation was observed between basal and rhTSH-stimulated Tg levels (|rho| = 0.48, P < .0001). The basal Tg level had significant diagnostic ability in predicting an rhTSH-stimulated Tg level of 2 ng/mL or higher, and the optimal basal Tg level for this prediction was 0.3 ng/mL (AUC = 0.77, P < .0001). A basal Tg level of 0.5 ng/mL was optimal for predicting rhTSH-stimulated Tg levels of 5 ng/mL or higher (AUC = 0.81, P < .0001), and of 10 ng/mL or higher (AUC = 0.82, P = .0171).The basal Tg level was significantly correlated with the rhTSH-stimulated Tg level. If the basal Tg level is >0.3 or 0.5 ng/mL, then the rhTSH-stimulated Tg level can be expected to be sufficiently high to necessitate clinical examination.
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Affiliation(s)
- Eugene Jeong
- Department of Nuclear Medicine and Molecular Imaging
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging
| | - Su Jin Lee
- Department of Nuclear Medicine and Molecular Imaging
| | - Euy Young Soh
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Jeonghun Lee
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Hyeung Kyoo Kim
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging
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Yoon JK, Byun C, Jo KS, Hur H, Lee KM, Lim SK, Lee D, Lee SJ, An YS, Han SU. Clinicopathologic parameters associated with the FDG-avidity in staging of early gastric cancer using 18F-FDG PET. Medicine (Baltimore) 2019; 98:e16690. [PMID: 31374056 PMCID: PMC6708908 DOI: 10.1097/md.0000000000016690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
This study investigated the clinicopathologic factors associated with 2-[F]fluoro-2-deoxy-D-glucose (F-FDG) uptake of early gastric cancer (EGC) and used them to design a clinical scoring method to predict FDG-avidity of EGC.Two hundred twenty-nine retrospectively enrolled patients underwent preoperative F-FDG positron emission tomography/computed tomography (PET/CT). Histologic information was obtained by gastrectomy (n = 195) or endoscopic mucosal dissection (n = 34). The association between clinicopathologic factors and F-FDG uptake by the primary tumor was determined. The results were used to develop a clinical scoring method.F-FDG uptake was detected in 49 (17.5%) patients. According to univariate analysis, location, gross type, World Health Organization classification, Lauren classification, size, depth of invasion, and lymphatic invasion were significant variables affecting F-FDG uptake (all P < .05). According to multivariate analysis, location (lower 3rd, P = .035), gross type (0-I, 0-IIa, P < .001), size (≥2.5 cm, P = .026), and depth of invasion (submucosa, P = .007) were significantly associated with FDG-avidity. A clinical scoring system, ranged from 0 to 4, was developed by giving one score to 4 independent variables. A cut-off value of 2.5 showed good prediction of FDG-avidity in EGCs, with a sensitivity and specificity of 65.0% and 85.2%, respectively.F-FDG uptake by EGC depends on location, gross type, size, and depth of invasion of the primary tumor. A clinical scoring system based on clinicopathologic variables can predict the FDG-avidity of primary tumors in patients with EGC.
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Affiliation(s)
- Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging
| | | | - Kyung Sook Jo
- Department of Nuclear Medicine and Molecular Imaging
| | | | | | | | - Dakeun Lee
- Department of Pathology, Ajou University School of Medicine, Suwon, Kyunggi-do, Republic of Korea
| | - Su Jin Lee
- Department of Nuclear Medicine and Molecular Imaging
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging
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Ryoo HG, Lee WW, Kim JY, Kong E, Choi WH, Yoon JK. Minimum Standardized Uptake Value from Quantitative Bone Single-Photon Emission Computed Tomography/Computed Tomography for Evaluation of Femoral Head Viability in Patients with Femoral Neck Fracture. Nucl Med Mol Imaging 2019; 53:287-295. [PMID: 31456862 DOI: 10.1007/s13139-019-00600-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2019] [Revised: 05/16/2019] [Accepted: 06/07/2019] [Indexed: 10/26/2022] Open
Abstract
Purpose Bone single-photon emission computed tomography/computed tomography (SPECT/CT) has been widely used for evaluation of femoral head viability in patients with femoral neck fracture. The current study aimed to investigate utility of standardized uptake value (SUV) from quantitative bone SPECT/CT for assessment of femoral head viability. Methods From March 2015 to November 2018, quantitative bone SPECT/CT was performed in 9 patients with non-viable femoral head post femoral neck fracture and in 31 controls. Maximum (SUVmax), mean (SUVmean), and minimum standardized uptake values (SUVmin) were measured over femoral head and neck. Mann-Whitney U test with Bonferroni correction was used to compare SUVs of ipsilateral and contralateral femurs from femoral neck fracture patients with those of control femurs. Results As for femoral head viability, SUVmax and SUVmean were not significantly decreased in non-viable femoral heads compared to those in controls. Only the SUVmin was significantly reduced in non-viable femoral heads (mean ± standard deviation, 0.57 ± 0.38) than in controls (0.95 ± 0.26, p = 0.006) and contralateral femoral heads (1.36 ± 0.59, p = 0.008). The cutoff SUVmin of 0.61 (g/mL) yielded a sensitivity of 77.8% and specificity of 87.1% for detection of non-viable femoral heads (p = 0.006). Contralateral femoral necks of the femoral neck fracture patients showed significantly higher SUVmean and SUVmin (3.17 ± 1.20 and 1.64 ± 0.63) than those of controls (2.32 ± 0.53 and 1.04 ± 0.27; p = 0.021 and p = 0.002, respectively), which seemed to reflect weight bearing effect or metabolic derangement. Conclusions The non-viable femoral heads from the femoral neck fracture showed significantly reduced SUVmin. Quantitative bone SPECT/CT holds promise for objective evaluation of femoral head viability.
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Affiliation(s)
- Hyun Gee Ryoo
- 1Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620 South Korea
| | - Won Woo Lee
- 1Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 82, Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do 13620 South Korea.,2Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, South Korea
| | - Ji Young Kim
- 3Department of Nuclear Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Seoul, South Korea
| | - Eunjung Kong
- 4Department of Nuclear Medicine, Yeungnam University Medical School and Hospital, Daegu, Gyeongsangbuk-do South Korea
| | - Woo Hee Choi
- 5Division of Nuclear Medicine, Department of Radiology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Joon-Kee Yoon
- 6Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Woldeukeom-ro, Suwon-si, South Korea
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Park BN, Lee SJ, Roh JH, Lee KH, An YS, Yoon JK. Radiolabeled Anti-Adenosine Triphosphate Synthase Monoclonal Antibody as a Theragnostic Agent Targeting Angiogenesis. Mol Imaging 2018; 16:1536012117737399. [PMID: 29239276 PMCID: PMC5734570 DOI: 10.1177/1536012117737399] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION The potential of a radioiodine-labeled, anti-adenosine triphosphate synthase monoclonal antibody (ATPS mAb) as a theragnostic agent for simultaneous cancer imaging and treatment was evaluated. METHODS Adenosine triphosphate synthase monoclonal antibody was labeled with radioiodine, then radiotracer uptake was measured in 6 different cancer cell lines. In vivo biodistribution was evaluated 24 and 48 hours after intravenous injection of 125I-ATPS mAb into MKN-45 tumor-bearing mice (n = 3). For radioimmunotherapy, 18.5 MBq 131I-ATPS mAb (n = 7), isotype immunoglobulin G (IgG) (n = 6), and vehicle (n = 6) were injected into MKN-45 tumor-bearing mice for 4 weeks, and tumor volume and percentage of tumor growth inhibition (TGI) were compared each week. RESULTS MKN-45 cells showed the highest in vitro cellular binding after 4 hours (0.00324 ± 0.00013%/μg), which was significantly inhibited by unlabeled ATPS mAb at concentrations of greater than 0.4 μM. The in vitro retention rate of 125I-ATPS mAb in MKN-45 cells was 64.1% ± 1.0% at 60 minutes. The highest tumor uptake of 125I-ATPS mAb in MKN-45 tumor-bearing mice was achieved 24 hours after injection (6.26% ± 0.47% injected dose [ID]/g), whereas tumor to muscle and tumor to blood ratios peaked at 48 hours. The 24-hour tumor uptake decreased to 3.43% ± 0.85% ID/g by blocking with unlabeled ATPS mAb. After 4 weeks of treatment, mice receiving 131I-ATPS mAb had significantly smaller tumors (679.4 ± 232.3 mm3) compared with control (1687.6 ± 420.4 mm3, P = .0431) and IgG-treated mice (2870.2 ± 484.1 mm3, P = .0010). The percentage of TGI of 131I-ATPS mAb was greater than 50% during the entire study period (range: 53.7%-75.9%). CONCLUSION The specific binding and antitumor effects of radioiodinated ATPS mAb were confirmed in in vitro and in vivo models of stomach cancer.
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Affiliation(s)
- Bok-Nam Park
- 1 Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
| | - Su Jin Lee
- 1 Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
| | - Jung Hyun Roh
- 1 Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
| | - Kyung-Han Lee
- 2 Department of Nuclear Medicine and Molecular Imaging, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Young-Sil An
- 1 Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
| | - Joon-Kee Yoon
- 1 Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, South Korea
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Abstract
Purpose: The purpose of this study was to investigate how intravenously injected bone marrow-derived mesenchymal stem cells (BMSCs) are distributed in the body of an Alzheimer’s disease (AD) animal model. Methods: Stem cells were collected from bone marrow of mice and labeled with Indium-111 (111In). The 111In-labeled BMSCs were infused intravenously into 3×Tg-AD mice in the AD group and non-transgenic mice (B6129SF2/J) as controls. Biodistribution was evaluated with a gamma counter and gamma camera 24 and 48 h after injecting the stem cells. Results: A gamma count of the brain showed a higher distribution of labeled cells in the AD model than in the control group at 24 (p = .0004) and 48 h (p = .0016) after injection of the BMSCs. Similar results were observed by gamma camera imaging (i.e., brain uptake in the AD model was significantly higher than that in the control group). Among the other organs, uptake by the spleen was the highest in both groups. More BMSCs were found in the lungs of the control group than in those of the AD group. Conclusions: These results suggest that more intravenously infused BMSCs reached the brain in the AD model than in the control group, but the numbers of stem cells reaching the brain was very small.
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Affiliation(s)
- Bok-Nam Park
- 1 Department of Nuclear Medicine and Molecular Imaging, Suwon, Korea
| | - Tae Sung Lim
- 2 Department of Neurology, Ajou University School of Medicine, Suwon, Korea
| | - Joon-Kee Yoon
- 1 Department of Nuclear Medicine and Molecular Imaging, Suwon, Korea
| | - Young-Sil An
- 1 Department of Nuclear Medicine and Molecular Imaging, Suwon, Korea
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Park S, Yoon JK, Chung NS, Kim SH, Hwang J, Lee HY, Kwack KS. Correlations between intravoxel incoherent motion diffusion-weighted MR imaging parameters and 18F-FDG PET/CT metabolic parameters in patients with vertebral bone metastases: initial experience. Br J Radiol 2018; 91:20170889. [PMID: 29509489 DOI: 10.1259/bjr.20170889] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE To investigate the relationship between intravoxel incoherent motion (IVIM) diffusion-weighted MRI (DW MRI) parameters and 18F-fluodeoxyglucose (FDG) (PET/CT) metabolic parameters in patients with vertebral bone metastases. METHODS 19 patients with vertebral bone metastases were retrospectively included in this institutional review board-approved study. All patients underwent IVIM DW-MRI and 18F-FDG PET/CT before treatment. The IVIM parameters [molecular diffusion coefficient (D), perfusion fraction (f), and perfusion-related D (D*)] and apparent diffusion coefficient were acquired using 11 b-values (0, 10, 15, 20, 25, 50, 80, 120, 200, 300, and 800 s mm-2). Maximum and mean standardized uptake values (SUVmax and SUVmean, respectively), metabolic tumor volume, and total lesion glycolysis derived from 18F-FDG PET/CT were calculated using thresholds of 3.0 SUV. The associations among parameters were evaluated by Spearman's correlation analysis. RESULTS A total of 19 patients and 41 regions of interest were included in this study. The IVIM parameter f was positively correlated with the metabolic parameters SUVmean and SUVmax [ρ = 0.499 (p < 0.01) and ρ = 0.413 (p < 0.01), respectively]. There was a weak positive correlation between D* and SUVmean (ρ = 0.321, p = 0.041). CONCLUSION IVIM perfusion-related parameters, especially f, were correlated with 18F-FDG PET/CT metabolic parameters in patients with vertebral bone metastases. IVIM DW-MRI, used to evaluate metabolic activity, appears to have diagnostic potential for bone metastasis and may also have utility in monitoring the post-treatment response. Advances in knowledge: The use of IVIM for vertebral bone metastasis is demonstrated. f may be more suitable to reflect the metabolic activity and may facilitate another diagnostic potential for monitoring the posttreatment response.
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Affiliation(s)
- Sunghoon Park
- 1 Department of Radiology, Ajou University School of Medicine , Suwon , South Korea.,2 Musculoskeletal Imaging Laboratory, Ajou University Medical Center , Suwon , South Korea
| | - Joon-Kee Yoon
- 3 Department of Nuclear Medicine and Molecular Imaging , Suwon , South Korea
| | - Nam-Su Chung
- 4 Department of Orthopaedic Surgery, Ajou University School of Medicine , Suwon , South Korea
| | - Sang Hyun Kim
- 5 Department of Neurosurgery, Ajou University School of Medicine , Suwon , South Korea
| | - Jinwoo Hwang
- 6 Department of Clinical Science, Philips Healthcare , Seoul , South Korea
| | - Hyun Young Lee
- 7 Regional Clinical Trial Center, Ajou University Medical Center , Suwon , South Korea.,8 Department of Biostatistics, Yonsei University College of Medicine , Seoul , South Korea
| | - Kyu-Sung Kwack
- 1 Department of Radiology, Ajou University School of Medicine , Suwon , South Korea.,2 Musculoskeletal Imaging Laboratory, Ajou University Medical Center , Suwon , South Korea
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Abstract
We performed this retrospective clinical study to examine the prognostic power of bone scintigraphy (BS) and F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) in terms of overall survival (OS) of breast cancer with bone-only metastasis.We retrospectively evaluated 100 female invasive ductal breast cancer patients (mean age 48.1 years) with bone-only metastasis. Twenty-five patients had human epidermal growth factor receptor 2 (HER2)-positive tumors, 65 were estrogen receptor (ER) and/or progesterone receptor (PR)-positive, HER2-negative tumors, and 10 were triple negative tumors. The patients were treated properly with various treatments, including chemotherapy, radiotherapy, hormone, and bisphosphonate therapy, based on their clinical status. All patients underwent BS and FDG PET/CT at baseline and 1 year after treatment. The baseline and follow images were visually compared, and the patients were grouped as responders or nonresponders based on their images. OS was compared between the groups.The mean OS after the diagnosis of bone-only metastasis was 57.6 months. Fifty-one patients (51%) died within 5 years after diagnosis of metastasis. No difference in survival was evident between responders and nonresponders based on BS imaging data (P = .090). The response status based on PET imaging data waste only significant independent prognostic factor on multivariate analysis (P = .001). Survival was lower in nonresponders than in responders based on PET imaging (32.7% vs 66.4%; P < .001).Our findings suggest that the response status according to FDG PET imaging can be used to predict OS in breast cancer patients with bone-only metastasis.
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Affiliation(s)
- Soyeon Park
- Department of Nuclear Medicine and Molecular Imaging
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging
| | - Su Jin Lee
- Department of Nuclear Medicine and Molecular Imaging
| | | | - Hyunee Yim
- Department of Pathology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging
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Park SY, Yoon JK, Lee SJ, Haam S, Jung J. Postoperative change of the psoas muscle area as a predictor of survival in surgically treated esophageal cancer patients. J Thorac Dis 2017; 9:355-361. [PMID: 28275484 DOI: 10.21037/jtd.2017.02.42] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Although a decrease in the psoas muscle area (PMA) has been reported as a risk factor for survival after esophagectomy in esophageal cancer, no previous studies have focused on the change in the PMA after surgery. We investigated the prognostic role of PMA changes in patients with surgically treated esophageal cancer. METHODS Fifty-eight patients with esophageal cancer who underwent surgical resection and complete lymph node dissection were reviewed retrospectively. The PMA was measured at the level of the L3 vertebrae on preoperative and one-year postoperative follow-up computed tomography images. The percentage change of the PMA was calculated as follows: delta (%) = (postoperative PMA - preoperative PMA) / (preoperative PMA × 100). RESULTS The study patients included 54 (93.1%) males and 4 females (mean age, 60.59±9.16 years), of whom 17 (29.3%) were pathological Stage I, 18 (31.0%) were Stage II, and 23 (39.7%) were Stage III. The mean change of the PMA was -10.17% and the postoperative PMA was decreased significantly compared with the preoperative PMA (P<0.001). The PMA was increased in 13 (22.4%) patients, whereas it was decreased in 45 (77.6%). Multivariate analysis revealed that the change of the PMA (hazard ratio, HR =0.688; P=0.001) and the pathologic stage (Stage III vs. Stage I, HR =3.388; P=0.016) were risk factors for overall survival (OS). The 3-year OS in patients with a PMA decrease of more than 10%, and those with a PMA decrease of less than 10% or an increase, were 18.9% and 59.5%, respectively (P=0.049). CONCLUSIONS The decrease in the PMA had a negative prognostic effect on OS in patients with surgically treated esophageal cancer.
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Affiliation(s)
- Seong Yong Park
- Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Su Jin Lee
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seokjin Haam
- Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Joonho Jung
- Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Republic of Korea
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Lee SJ, Park BN, Roh JH, An YS, Hur H, Yoon JK. Enhancing the Therapeutic Efficacy of 2-Deoxyglucose in Breast Cancer Cells Using Cell-cycle Synchronization. Anticancer Res 2017; 36:5975-5980. [PMID: 27793923 DOI: 10.21873/anticanres.11185] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 09/15/2016] [Indexed: 11/10/2022]
Abstract
AIM We assessed the effect of cell-cycle synchronization using the T-type calcium channel inhibitor mibefradil on the anticancer effects of 2-deoxy-D-glucose (2-DG) and glucose metabolism in breast cancer cells. MATERIALS AND METHODS MDA-MB-231 cells were treated with mibefradil, followed by 2-DG with/without paclitaxel, then cells were assessed for viability. Glucose metabolism was evaluated by 3H-2-DG uptake, lactate concentration, and membrane glucose transporter 1 expression after mibefradil treatment. RESULTS Viability was significantly lower in cells receiving the combination therapy of mibefradil and 2-DG relative to 2-DG treatment alone; addition of paclitaxel to the combination therapy further reduced the viability of breast cancer cells. Withdrawal of mibefradil resulted in a significant increase in cellular 3H-2-DG uptake uptake, a slight accumulation of lactate, and increased membrane glucose transporter 1 expression. CONCLUSION Mibefradil-induced cell-cycle synchronization enhanced the anticancer activity of 2-DG in breast cancer cells due to an increase in cellular glucose metabolism.
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Affiliation(s)
- Su Jin Lee
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Bok-Nam Park
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jung Hyun Roh
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Hoon Hur
- Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Republic of Korea
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Park SY, Lee SJ, Yoon JK. The prognostic value of total lesion glycolysis via 18F-fluorodeoxyglucose PET-CT in surgically treated esophageal squamous cell carcinoma. Ann Nucl Med 2016; 30:81-8. [PMID: 26497543 DOI: 10.1007/s12149-015-1034-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 10/19/2015] [Indexed: 12/22/2022]
Abstract
OBJECTIVE In addition to staging, the identification of prognostic factors is important for predicting survival in patients with esophageal cancer after esophagectomy. The present study was performed to document the prognostic role of total lesion glycolysis (TLG) in postoperative patients. METHODS We retrospectively reviewed the records of 50 patients with esophageal squamous cell carcinoma who underwent surgical resection and complete lymph node dissection after positron emission tomography-computed tomography (PET-CT). A volume of interest was drawn on the primary lesion and suspected metastatic lymph nodes, and the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), TLG of the primary lesion (TLGp), and whole-body TLG (TLGwb) were measured using an SUV cutoff of 2.5. RESULTS The study population included 50 patients with a mean age of 63.14 ± 8.18 years: 12 (24%) were reported as stage I, 13 (26%) as stage II, and 25 (50%) as stage III. The median follow-up period was 20.46 months, and recurrences occurred in 17 patients. The mean SUVmax, MTV, TLGp, and TLGwb were 11.11 ± 6.40, 20.47 ± 22.88, 122.54 ± 180.98, and 129.37 ± 193.66, respectively. On the multivariate analysis, TLGp was a risk factor for disease-free survival (DFS) [hazard ratio (HR) = 1.002, p = 0.026], and TLGwb was a risk factor for DFS (HR = 1.002, p = 0.021) and overall survival (OS) (HR = 1.002, p = 0.044). The 3-year OS rates were 66.1% in patients with low TLGwb (≤ 41.45) and 33.3% in those with high TLGwb (>41.45; p = 0.004). The concordance index of the TLGwb was 0.752 (95% CI 0.659-0.845). CONCLUSION TLGwb is a significant prognostic factor for OS and DFS in patients with surgically treated esophageal squamous cell carcinoma.
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Kim TH, Yoon JK, Kang DK, Kang SY, Jung YS, Han S, Kim JY, Yim H, An YS. Value of volume-based metabolic parameters for predicting survival in breast cancer patients treated with neoadjuvant chemotherapy. Medicine (Baltimore) 2016; 95:e4605. [PMID: 27741099 PMCID: PMC5072926 DOI: 10.1097/md.0000000000004605] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
We evaluated the role of metabolic parameters in the prediction of disease recurrence in operable invasive ductal breast cancer patients treated with neoadjuvant chemotherapy (NAC).We retrospectively evaluated 139 female patients (mean age, 46.5 years; range: 27-72 years) with invasive ductal breast cancer, treated with NAC followed by surgery. All patients underwent F-fluorodeoxyglucose positron emission tomography/computed tomography and magnetic resonance imaging at baseline and after completion of NAC before surgery. The prognostic significance of clinicopathological and imaging parameters for disease-free survival (DFS) was evaluated.Recurrence of cancer was detected in 31 of 139 patients (22.3%; follow-up period: 6-82 months). Baseline maximum standardized uptake value, metabolic tumor volume (MTV), and reduction rate (RR) of MTV after NAC were significant independent prognostic factors for DFS in a multivariate analysis (all P < 0.05). The survival functions differed significantly between low and high histological grades (P < 0.001). DFS of the patients with high baseline MTV (≥5.23 cm) was significantly poorer than that of low MTV patients (P = 0.019). The survival function of the group with low RR of MTV after NAC (≤90.72%) was poorer than the higher RR of the MTV group (P = 0.008).Our findings suggest that breast cancer patients who have a high histological grade, large baseline MTV, or a small RR of MTV after NAC should receive great attention to check for possible recurrence.
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Affiliation(s)
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging
| | | | | | | | | | | | - Hyunee Yim
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging
- Correspondence: Young-Sil An, Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University, Woncheon-dong, Yeongtong-gu, Gyeonggi-do, Suwon 443-749, Korea (e-mail: )
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Park SY, Yoon JK, Lee SJ, Haam S, Jung J. Prognostic value of preoperative total psoas muscle area on long-term outcome in surgically treated oesophageal cancer patients. Interact Cardiovasc Thorac Surg 2016; 24:13-19. [PMID: 27587471 DOI: 10.1093/icvts/ivw274] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 06/20/2016] [Accepted: 06/27/2016] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES Although a decrease in psoas muscle area (PMA) has been reported as a risk factor for survival in several malignancies, there have been few studies regarding its prognostic value in oesophageal cancer. We investigated the prognostic role of PMA and its F-18 fluorodeoxyglucose uptake in patients who had surgically treated oesophageal cancer. METHODS From 2004 to 2013, 131 patients who underwent surgical resection and complete lymph node dissection for oesophageal cancer were retrospectively reviewed. The PMA and mean standardized uptake value (SUVmean) of the psoas muscle were measured at the L3 spine level on preoperative positron emission tomography/computed tomography images. RESULTS The mean age was 63.38 ± 8.47 years and male patients were 125 (95.4%). The pathological stage I, II and III were 38 (29.0%), 41 (31.3%) and 52 (39.7%), respectively. The mean body mass index (BMI), PMA and SUVmean of the psoas muscle were 59.50 ± 10.14, 14.42 ± 4.30 and 1.51 ± 0.27, respectively. Operative mortality occurred in 7 (5.3%) patients. The BMI and PMA were lower in patients with operative mortality than in patients who survived. The median follow-up time was 32.52 months. A multivariate analysis revealed that PMA was an adverse risk factor for overall survival (OS) (hazard ratio, HR = 0.930; P= 0.004), whereas BMI was related to OS. The 3-year OS rates were 64.9% in high-PMA (≥15.8) patients; however, it was only 37.1% in low-PMA (less than 15.8) patients (P= 0.002). Akaike information criterion was the lowest by including PMA in the multivariate model. CONCLUSIONS Decreased PMA was an adverse significant prognostic factor for OS in patients with oesophageal cancer.
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Affiliation(s)
- Seong Yong Park
- Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Su Jin Lee
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seokjin Haam
- Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Joonho Jung
- Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, Suwon, Republic of Korea
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An YS, Yoon JK, Lee SJ, Jeong SH, Lee HW. Clinical significance of post-treatment 18F-fluorodeoxyglucose uptake in cervical lymph nodes in patients with diffuse large B-cell lymphoma. Eur Radiol 2016; 26:4632-4639. [PMID: 27193777 DOI: 10.1007/s00330-016-4365-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Revised: 02/15/2016] [Accepted: 04/11/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVES We assessed the clinical significance of FDG uptake in cervical lymph nodes after treatment of patients with DLBCL. METHODS In total, 87 patients with DLBCL were enrolled. All patients had newly appeared FDG uptake in cervical lymph nodes on PET/CT during follow-up after cessation of therapy. Cervical lymph nodes were finally diagnosed as benign or malignant according to histopathological findings or follow-up PET. Clinical characteristics and PET findings were compared between groups and factors associated with malignant lesions were evaluated. RESULTS Only 8 (9.2 %) patients with cervical lymph nodes with FDG uptake ultimately had malignancy. FDG uptake lymph nodes appeared significantly earlier in the malignant group than in patients with benign FDG uptake (p = 0.013). Primary nodal lymphoma was more frequent in patients with cancer spread than in those with benign FDG uptake in lymph nodes (p < 0.001). CONCLUSION Most cervical lymph nodes with FDG uptake (about 91 %) appearing after treatment of malignant DLBCL were ultimately benign. The elapsed time between the end of therapy and the appearance of cervical lymph nodes with FDG uptake and the primary sites of lymphomas are helpful clues in determining which cases are malignant. KEY POINTS • About 91 % appearing after treatment of DLBCL were benign. • Elapsed time between therapy and FDG uptake was associated with malignancy. • Primary sites of lymphoma are helpful clues to determine malignancy.
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Affiliation(s)
- Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Woncheon-dong, Yeongtong-gu, Gyeonggi-do, Suwon-si, Korea, 443-749.
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Woncheon-dong, Yeongtong-gu, Gyeonggi-do, Suwon-si, Korea, 443-749
| | - Su Jin Lee
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Woncheon-dong, Yeongtong-gu, Gyeonggi-do, Suwon-si, Korea, 443-749
| | - Seong Hyun Jeong
- Department of Hematology-Oncology, Ajou University School of Medicine, Woncheon-dong, Yeongtong-gu, Gyeonggi-do, Suwon, Korea
| | - Hyun Woo Lee
- Department of Hematology-Oncology, Ajou University School of Medicine, Woncheon-dong, Yeongtong-gu, Gyeonggi-do, Suwon, Korea
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Yoon JK, Choi J, Lee HJ, Cho Y, Gwon YD, Jang Y, Kim S, Choi H, Lee JH, Kim YB. Distribution of Porcine Endogenous Retrovirus in Different Organs of the Hybrid of a Landrace and a Jeju Domestic Pig in Korea. Transplant Proc 2016; 47:2067-71. [PMID: 26293098 DOI: 10.1016/j.transproceed.2015.05.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 05/22/2015] [Indexed: 01/30/2023]
Abstract
Xenotransplantation offers a solution to the shortage of available organs for transplantation, and the pig represents an ideal source of such organs. However, porcine endogenous retrovirus (PERV), whose genome is integrated in pigs, has been suggested to pose a potential risk of xenotransmission. Expression of PERVs in different organs of pigs was carefully measured at DNA, mRNA, and protein levels, providing information valuable for the application of pig organs in xenotransplantation. An analysis of PERV DNA showed that a very similar number of PERV copies was present in the genome of all organs, whereas mRNA and protein levels of PERV varied depending on the organ, with kidney, liver, and spleen expressing high levels of both mRNA and protein. In contrast, mRNA and protein levels were dissimilar in the lung and brain, where mRNA levels were low but protein levels were high. This discrepancy indicates that mRNA levels are not always reflected in protein expression. In addition, the difference between mRNA and protein highlights the importance of choosing the proper analysis method for diagnosing viral infection. In summary, this study provides insight into the distribution of PERV in various organs at the DNA, mRNA, and protein levels, and also informs the proper selection of tissues or organs for future clinical xenotransplantation.
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Affiliation(s)
- J K Yoon
- Department of Bio-industrial Technologies, Konkuk University, Seoul, Korea
| | - J Choi
- Department of Bio-industrial Technologies, Konkuk University, Seoul, Korea
| | - H J Lee
- Department of Bio-industrial Technologies, Konkuk University, Seoul, Korea
| | - Y Cho
- Department of Bio-industrial Technologies, Konkuk University, Seoul, Korea
| | - Y D Gwon
- Department of Bio-industrial Technologies, Konkuk University, Seoul, Korea
| | - Y Jang
- Department of Bio-industrial Technologies, Konkuk University, Seoul, Korea
| | - S Kim
- Department of Bio-industrial Technologies, Konkuk University, Seoul, Korea
| | - H Choi
- Department of Bio-industrial Technologies, Konkuk University, Seoul, Korea
| | - J H Lee
- College of Veterinary Medicine, Konkuk University, Seoul, Korea
| | - Y B Kim
- Department of Bio-industrial Technologies, Konkuk University, Seoul, Korea.
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Kwon SH, Hyun SH, Yoon JK, An YS, Oh YT, Choi JH, Park KJ, Lee SJ. The Highest Metabolic Activity on FDG PET Is Associated With Overall Survival in Limited-Stage Small-Cell Lung Cancer. Medicine (Baltimore) 2016; 95:e2772. [PMID: 26844524 PMCID: PMC4748941 DOI: 10.1097/md.0000000000002772] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
We evaluated the prognostic value of F-fluorodeoxyglucose positron emission tomography (FDG PET) parameters for limited-stage small-cell lung cancer (LS-SCLC).We retrospectively enrolled 59 LS-SCLC patients who underwent pretreatment FDG PET/CT. Various PET parameters were measured in all malignant lesions, and we recorded the highest maximum standardized uptake value (SUVmax), and sum of metabolic tumor volume (MTVsum) and total lesion glycolysis (TLGsum). The relationship between the highest SUVmax and volumetric PET parameters was evaluated. The prognostic significances of PET parameters and clinical variables were assessed using Cox's proportional hazard regression analysis. Overall survival (OS) and progression-free survival (PFS) were assessed by the Kaplan-Meier method.The SUVmax of the highest metabolic lesion had a significant positive correlation with MTVsum and TLGsum (P < 0.001). Upon multivariate analysis, the highest SUVmax was an independent predictor of OS (1 unit increase, hazard ratio [HR]: 1.133, P = 0.003) and MTVsum was a significant prognostic factor of PFS (10-cm increase, HR: 1.027, P = 0.034) after adjusting for age, sex, performance status, tumor stage, and treatment modality. The highest SUVmax was a prognostic factor for PFS with marginal significance (1 unit increase, HR: 1.078, P = 0.053). Patients with higher SUVmax (≥11) were also characterized by a significantly shorter median OS (P < 0.001) and PFS (P = 0.002) compared with patients with lower SUVmax.The highest SUVmax is an independent prognostic factor for survival in LS-SCLC patients. Therefore, the highest SUVmax might be a possible imaging biomarker for risk stratification in LS-SCLC. A further study in a large cohort is needed to validate the prognostic significance of the parameter.
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Affiliation(s)
- Soo Hyun Kwon
- From the Department of Nuclear Medicine, Ajou University School of Medicine, Suwon (SHK, J-KY, Y-SA, SJL); Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (SHH); Department of Radiation Oncology (Y-TO); and Department of Internal Medicine, Ajou University School of Medicine, Suwon, Korea (J-HC, KJP)
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Choi BH, Yoon SH, Song SI, Yoon JK, Lee SJ, An YS. Comparison of Diagnostic Performance Between Visual and Quantitative Assessment of Bone Scintigraphy Results in Patients With Painful Temporomandibular Disorder. Medicine (Baltimore) 2016; 95:e2485. [PMID: 26765456 PMCID: PMC4718282 DOI: 10.1097/md.0000000000002485] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
This retrospective clinical study was performed to evaluate whether a visual or quantitative method is more valuable for assessing painful temporomandibular disorder (TMD) using bone scintigraphy results.In total, 230 patients (172 women and 58 men) with TMD were enrolled. All patients were questioned about their temporomandibular joint (TMJ) pain. Bone scintigraphic data were acquired in all patients, and images were analyzed by visual and quantitative methods using the TMJ-to-skull uptake ratio. The diagnostic performances of both bone scintigraphic assessment methods for painful TMD were compared.In total, 241 of 460 TMJs (52.4%) were finally diagnosed with painful TMD. The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the visual analysis for diagnosing painful TMD were 62.8%, 59.6%, 58.6%, 63.8%, and 61.1%, respectively. The quantitative assessment showed the ability to diagnose painful TMD with a sensitivity of 58.8% and specificity of 69.3%. The diagnostic ability of the visual analysis for diagnosing painful TMD was not significantly different from that of the quantitative analysis.Visual bone scintigraphic analysis showed a diagnostic utility similar to that of quantitative assessment for the diagnosis of painful TMD.
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Affiliation(s)
- Bong-Hoi Choi
- From the Department of Nuclear Medicine and Molecular Imaging, Gyeongsang National University Hospital, Jinju; Department of Nuclear Medicine and Molecular Imaging, Asan Medical Center, University of Ulsan College of Medicine, Seoul; Division of Oral and Maxillofacial Surgery, Department of Dentistry; and Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
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Abstract
BRAFV600E mutation and F-18 fluorodeoxyglucose (FDG) uptake are potential prognostic factors of papillary thyroid cancer (PTC). This study was performed to investigate the relationship between the BRAFV600E mutation and F-18 FDG uptake in PTC.We retrospectively included 169 PTC patients who underwent F-18 FDG positron emission tomography/computed tomography (PET/CT) before thyroidectomy from May 2009 to August 2012. Subjects were classified into overt PTC (>1 cm, n = 76) and papillary thyroid microcarcinoma (PTMC, n = 93) groups. Univariate and multivariate analyses were performed to assess the relationship between maximum standardized uptake value (SUVmax) of the primary tumors and clinicopathologic variables.The BRAFV600E mutation was detected in 82.2% (139/169). In all subjects, the BRAFV600E mutation and tumor size were independently related to SUVmax by multivariate analysis (P = 0.048 and P < 0.001, respectively). SUVmax was significantly higher in tumors with the BRAFV600E mutation than in those with wild-type BRAF (9.4 ± 10.9 vs 5.0 ± 4.1, P < 0.001). Similarly, in overt PTC group, the BRAFV600E mutation and tumor size were independently correlated with SUVmax (P = 0.032 and P = 0.001, respectively). By contrast, in PTMC group, only tumor size was significantly associated with SUVmax (P = 0.010). The presence of the BRAFV600E mutation is independently associated with high F-18 FDG uptake on preoperative PET/CT in patients with overt PTC, but this relationship was not evident in PTMC. This study provides a better understanding of the relationship between F-18 FDG uptake and BRAFV600E mutation in patients with PTC.
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Affiliation(s)
- Seokho Yoon
- From the Department of Nuclear Medicine and Molecular Imaging (SY, Y-SA, SJL, J-KY); Department of Surgery (EYS); Department of Pathology (J-HK); and Department of Endocrinology and Metabolism (Y-SC), Ajou University School of Medicine, Suwon, Republic of Korea
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Kim TH, Yoon JK, Kang DK, Lee SJ, Jung YS, Yim H, An YS. Correlation Between F-18 Fluorodeoxyglucose Positron Emission Tomography Metabolic Parameters and Dynamic Contrast-Enhanced MRI-Derived Perfusion Data in Patients with Invasive Ductal Breast Carcinoma. Ann Surg Oncol 2015; 22:3866-72. [PMID: 25805237 DOI: 10.1245/s10434-015-4526-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2014] [Indexed: 11/18/2022]
Abstract
PURPOSE The aim of this study was to establish possible relationships among the metabolic and vascular characteristics of breast cancer using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) imaging. METHODS Sixty-seven female patients with invasive ductal breast carcinoma (age 32-79 years) who underwent FDG PET/CT and DCE-MRI prior to cancer treatment were included in the study. The maximum standardized uptake value (SUVmax), metabolic tumor volume, total lesion glycolysis (TLG), and heterogeneity factor (HF) were derived from FDG PET/CT. The DCE-MRI parameters K trans, K ep, and V e were obtained for all tumors, and relationships between the metabolic and perfusion parameters were sought via Spearman's rank correlation analysis. The prognostic significance of clinicopathological and imaging parameters in terms of recurrence-free survival (RFS) was also evaluated. RESULTS No significant correlation between perfusion and metabolic parameters (p > 0.05) was found, except between SUVmax and V e (p = 0.001, rho = -0.391). Recurrence developed in 12 of the 67 patients (17.9 %, follow-up period 8-41 months). Age (p = 0.016) and HF (p = 0.027) were significant independent predictors of recurrence-free survival (RFS) upon multivariate analysis. The RFS of patients under 40 years of age was significantly poorer than that of older patients (p < 0.001). Survival of patients with more heterogeneous tumors (HF less than -0.12) was poorer than those with relatively homogenous tumors (p = 0.033). CONCLUSIONS Tumors with higher levels of glucose metabolism (SUVmax values) exhibited higher tumor cellularities (V e values). Also, of the various metabolic and perfusion parameters available, tumor heterogeneity measured via FDG PET/CT (HF) may be useful in predicting RFS in breast cancer patients.
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Affiliation(s)
- Tae Hee Kim
- Department of Radiology, Ajou University School of Medicine, Suwon, Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Doo Kyoung Kang
- Department of Radiology, Ajou University School of Medicine, Suwon, Korea
| | - Su Jin Lee
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Yong Sik Jung
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Hyunee Yim
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, School of Medicine, Ajou University School of Medicine, Suwon, Korea.
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Song H, Lee D, Park SY, An YS, Yoon JK, Lee SJ. Single Pulmonary Langerhans Cell Histiocytosis Mimicking Metastasis in Lung Cancer: Imaging with (18)F-FDG PET/CT. Nucl Med Mol Imaging 2015; 49:243-5. [PMID: 26279700 DOI: 10.1007/s13139-015-0326-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 02/10/2015] [Accepted: 02/12/2015] [Indexed: 10/23/2022] Open
Affiliation(s)
- Heesung Song
- Department of Nuclear Medicine, Jeju National University School of Medicine, Jeju, Republic of Korea
| | - Dakeun Lee
- Departments of Pathology, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Seong Yong Park
- Thoracic Surgery, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Young-Sil An
- Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380 Republic of Korea
| | - Joon-Kee Yoon
- Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380 Republic of Korea
| | - Su Jin Lee
- Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380 Republic of Korea
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Kwon SH, Chung YS, Lee DH, Jo KS, An YS, Yoon JK, Lee SJ. Incidentally Detected Juvenile-Pattern Bone Scintigraphy in a Young Man with Kallmann’s Syndrome. Nucl Med Mol Imaging 2014; 48:247-8. [DOI: 10.1007/s13139-014-0264-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2013] [Revised: 01/05/2014] [Accepted: 01/09/2014] [Indexed: 12/01/2022] Open
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Lee D, Kim YC, Lee KM, Yoon JK, Kim YB. MET-Amplified Intramucosal Gastric Cancer Widely Metastatic after Complete Endoscopic Submucosal Dissection. Cancer Res Treat 2014; 47:120-5. [PMID: 25152190 PMCID: PMC4296859 DOI: 10.4143/crt.2013.137] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Accepted: 10/15/2013] [Indexed: 01/17/2023] Open
Abstract
Intramucosal gastric cancer (IGC) is associated with a very low risk of lymph node metastasis; thus it is the main candidate for minimally invasive surgical procedures, such as endoscopic submucosal dissection (ESD). Herein, we document an extraordinary case of IGC, which showed a very aggressive clinical course. A 66-year-old female underwent ESD for early gastric cancer. Histologically, the tumor consisted mainly of moderately differentiated adenocarcinoma measuring 1.6 cm in diameter, and the tumor was confined to the mucosa. Despite annual esophagogastroduodenoscopic follow-up, the tumor recurred, with wide metastasis to multiple lymph nodes and bones throughout the body after three years. Fluorescence in situ hybridization study demonstrated MET gene amplification as well as low grade polysomy 7 in both original and recurrent tumors. The clinical characteristics of metastatic IGCs and the implication of MET amplification are discussed.
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Affiliation(s)
- Dakeun Lee
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
| | - Young Chul Kim
- Department of Radiology, Ajou University School of Medicine, Suwon, Korea
| | - Kee Myung Lee
- Department of Gastroenterology, Ajou University School of Medicine, Suwon, Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
| | - Young-Bae Kim
- Department of Pathology, Ajou University School of Medicine, Suwon, Korea
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Kwon SH, Yoon JK, An YS, Shin YS, Kim CH, Lee DH, Jo KS, Lee SJ. Prognostic significance of the intratumoral heterogeneity of (18) F-FDG uptake in oral cavity cancer. J Surg Oncol 2014; 110:702-6. [PMID: 24975131 DOI: 10.1002/jso.23703] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 05/26/2014] [Indexed: 01/08/2023]
Abstract
BACKGROUNDS We evaluated the prognostic value of the intratumoral heterogeneity of (18) F-FDG uptake in oral cavity cancer. MATERIALS AND METHODS We enrolled 45 patients who underwent pretreatment (18) F-FDG PET/CT. The intratumoral heterogeneity of (18) F-FDG uptake was represented as the heterogeneity factor (HF), defined as the derivative (dV/dT) of a volume-threshold function for a primary tumor. We measured the maximum standardized uptake value (SUVmax ) and volumetric PET parameters. The relationship between HF and clinical parameters, as well as other PET parameters, was evaluated. RESULTS The HF was significantly correlated with SUVmax (r = -0.353, P = 0.017), metabolic tumor volume (r = -0.708, P < 0.0001), and total lesion glycolysis (r = -0.709, P < 0.0001). A multivariate analysis revealed not only cervical lymph node metastasis (hazard ratio = 5.983; P = 0.022) but also HF (hazard ratio = 2.49 × 10(-4) ; P = 0.002) to be independent predictors of overall survival. Those patients with HF < -0.13 showed a worse prognosis than those with HF ≥ -0.13 (P = 0.005). CONCLUSIONS The intratumoral heterogeneity of (18) F-FDG uptake may be a significant prognostic factor for overall survival in addition to cervical lymph node metastasis in oral cavity cancer. J. Surg. Oncol. 2014 110:702-706. © 2014 Wiley Periodicals, Inc.
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Affiliation(s)
- Soo Hyun Kwon
- Departments of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, Korea
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Lee DH, Lee SJ, Lee DJ, Kwon SH, Jo KS, An YS, Yoon JK. Carotid Artery FDG Uptake May Serve as a Biomarker for Cardiovascular Risk Stratification in Asymptomatic Adults. Nucl Med Mol Imaging 2014; 48:196-202. [PMID: 25177376 DOI: 10.1007/s13139-014-0277-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2014] [Revised: 03/31/2014] [Accepted: 04/09/2014] [Indexed: 11/30/2022] Open
Abstract
PURPOSE We investigated the relation between carotid artery FDG uptake and cardiovascular risk based on the Framingham risk score (FRS) and evaluated the possible role of FDG uptake in terms of risk stratification of asymptomatic adults. METHODS We evaluated 290 adults who underwent FDG PET/CT as part of general health screens. We calculated target-to-background ratios, corrected for pre-scan blood glucose levels, and obtained "TBRglu" values for both common carotid arteries. The FRS and the presence/absence of metabolic syndrome were recorded for each subject. Relationships among TBRglu values, metabolic syndrome status, and clinical parameters were assessed. RESULTS Carotid artery FDG uptake was significantly associated with clinical risk factors. Stepwise multiple regression analysis revealed that triglyceride levels, diabetes, and metabolic syndrome were independent determinants of high TBRglu. Of subjects with metabolic syndrome, those exhibiting high carotid artery FDG uptake had significantly higher levels of high sensitivity C-reactive protein (hsCRP). In subjects who did not have metabolic syndrome, FRSs were significantly elevated in those exhibiting high carotid artery FDG uptake compared to those with low uptake (13.1 ± 7.0 vs. 8.2 ± 7.4), as was also true of subjects with the syndrome (21.8 ± 16.0 vs. 13.5 ± 11.9). CONCLUSION High carotid FDG uptake is significantly associated with clinical risk factors and a greater FRS. Of subjects with metabolic syndrome, those with high carotid uptake had significantly higher hsCRP concentrations and FRSs. Therefore, carotid artery FDG activity may serve as a possible biomarker allowing cardiovascular risk stratification of asymptomatic populations.
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Affiliation(s)
- Dong Hyun Lee
- Departments of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380 Republic of Korea
| | - Su Jin Lee
- Departments of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380 Republic of Korea
| | - Duck-Joo Lee
- Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Soo Hyun Kwon
- Departments of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380 Republic of Korea
| | - Kyung-Sook Jo
- Departments of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380 Republic of Korea
| | - Young-Sil An
- Departments of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380 Republic of Korea
| | - Joon-Kee Yoon
- Departments of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, 164, World cup-ro, Yeongtong-gu, Suwon, 443-380 Republic of Korea
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Jo KS, An YS, Lee SJ, Soh EY, Lee J, Chung YS, Kim DJ, Yoon SH, Lee DH, Yoon JK. Significance of Salivary Gland Radioiodine Retention on Post-ablation (131)I Scintigraphy as a Predictor of Salivary Gland Dysfunction in Patients with Differentiated Thyroid Carcinoma. Nucl Med Mol Imaging 2014; 48:203-11. [PMID: 25177377 DOI: 10.1007/s13139-014-0274-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2014] [Revised: 03/23/2014] [Accepted: 03/26/2014] [Indexed: 11/28/2022] Open
Abstract
PURPOSE We investigated whether (131)I whole-body scintigraphy could predict functional changes in salivary glands after radioiodine therapy. METHODS We evaluated 90 patients who received initial high-dose (≥3.7 GBq) radioiodine therapy after total thyroidectomy. All patients underwent diagnostic (DWS) and post-ablation (TWS) (131)I whole-body scintigraphy. Visual assessment of salivary radioiodine retention on DWS and TWS was used to divide the patients into two types of groups: a DWS+ or DWS- group and a TWS+ or TWS- group. Salivary gland scintigraphy was also performed before DWS and at the first follow-up visit. Peak uptake and %washout were calculated in ROIs of each gland. Functional changes (Δuptake or Δwashout) of salivary glands after radioiodine therapy were compared between the two groups. RESULTS Both peak uptake and the %washout of the parotid glands were significantly lower after radioiodine therapy (all p values <0.001), whereas only the %washout were significantly reduced in the submandibular glands (all p values <0.05). For the parotid glands, the TWS+ group showed larger Δuptake and Δwashout after radioiodine therapy than did the TWS- group (all p values <0.01). In contrast, the Δuptake and Δwashout of the submandibular glands did not significantly differ between the TWS+ and TWS- groups (all p values >0.05). Likewise, no differences in Δuptake or Δwashout were apparent between the DWS+ and DWS- groups in either the parotid or submandibular glands (all p values >0.05). CONCLUSION Salivary gland radioiodine retention on post-ablation (131)I scintigraphy is a good predictor of functional impairment of the parotid glands after high-dose radioiodine therapy.
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Affiliation(s)
- Kyung Sook Jo
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 443-380
| | - Young-Sil An
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 443-380
| | - Su Jin Lee
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 443-380
| | - Euy-Young Soh
- Department of Surgery, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 443-380
| | - Jeonghun Lee
- Department of Surgery, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 443-380
| | - Yoon-Sok Chung
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 443-380
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 443-380
| | - Seok-Ho Yoon
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 443-380
| | - Dong Hyun Lee
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 443-380
| | - Joon-Kee Yoon
- Department of Nuclear Medicine & Molecular Imaging, Ajou University School of Medicine, 164, World Cup-ro, Yeongtong-gu, Suwon, Kyunggi-do Republic of Korea 443-380
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Yoon SH, Lee S, Jo KS, Lee DH, An YS, Yoon JK, Lee SJ. Inflammatory pseudotumor in the mediastinum: imaging with (18)F-fluorodeoxyglucose PET/CT. Korean J Radiol 2013; 14:673-6. [PMID: 23901326 PMCID: PMC3725363 DOI: 10.3348/kjr.2013.14.4.673] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 03/31/2013] [Indexed: 11/15/2022] Open
Abstract
Mediastinal inflammatory pseudotumor is a rare benign disease with its capability for local invasion and rapid growth. We present a case of middle-mediastinal inflammatory pseudotumor and report its contrast-enhanced chest computed tomography, (18)F-fluorodeoxyglucose positron emission tomography/computed tomography and pathologic findings.
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Affiliation(s)
- Seok-Ho Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon 443-721, Korea
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An YS, Yoon JK, Lee SJ, Song HS, Yoon SH, Jo KS. Symptomatic late-onset sialadenitis after radioiodine therapy in thyroid cancer. Ann Nucl Med 2013; 27:386-91. [DOI: 10.1007/s12149-013-0697-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2012] [Accepted: 01/29/2013] [Indexed: 11/28/2022]
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Levi J, Kothapalli SR, Bohndiek S, Yoon JK, Dragulescu-Andrasi A, Nielsen C, Tisma A, Bodapati S, Gowrishankar G, Yan X, Chan C, Starcevic D, Gambhir SS. Molecular photoacoustic imaging of follicular thyroid carcinoma. Clin Cancer Res 2013; 19:1494-502. [PMID: 23349314 DOI: 10.1158/1078-0432.ccr-12-3061] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
PURPOSE To evaluate the potential of targeted photoacoustic imaging as a noninvasive method for detection of follicular thyroid carcinoma. EXPERIMENTAL DESIGN We determined the presence and activity of two members of matrix metalloproteinase family (MMP), MMP-2 and MMP-9, suggested as biomarkers for malignant thyroid lesions, in FTC133 thyroid tumors subcutaneously implanted in nude mice. The imaging agent used to visualize tumors was MMP-activatable photoacoustic probe, Alexa750-CXeeeeXPLGLAGrrrrrXK-BHQ3. Cleavage of the MMP-activatable agent was imaged after intratumoral and intravenous injections in living mice optically, observing the increase in Alexa750 fluorescence, and photoacoustically, using a dual-wavelength imaging method. RESULTS Active forms of both MMP-2 and MMP-9 enzymes were found in FTC133 tumor homogenates, with MMP-9 detected in greater amounts. The molecular imaging agent was determined to be activated by both enzymes in vitro, with MMP-9 being more efficient in this regard. Both optical and photoacoustic imaging showed significantly higher signal in tumors of mice injected with the active agent than in tumors injected with the control, nonactivatable, agent. CONCLUSIONS With the combination of high spatial resolution and signal specificity, targeted photoacoustic imaging holds great promise as a noninvasive method for early diagnosis of follicular thyroid carcinomas.
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Affiliation(s)
- Jelena Levi
- Canary Center at Stanford for Cancer Early Detection, Stanford University, Palo Alto, California 94305, USA
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Ito K, Smith BR, Parashurama N, Yoon JK, Song SY, Miething C, Mallick P, Lowe S, Gambhir SS. Unexpected dissemination patterns in lymphoma progression revealed by serial imaging within a murine lymph node. Cancer Res 2012; 72:6111-8. [PMID: 23033441 DOI: 10.1158/0008-5472.can-12-2579] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Non-Hodgkin lymphoma (NHL) is a heterogeneous and highly disseminated disease, but the mechanisms of its growth and dissemination are not well understood. Using a mouse model of this disease, we used multimodal imaging, including intravital microscopy (IVM) combined with bioluminescence, as a powerful tool to better elucidate NHL progression. We injected enhanced green fluorescent protein and luciferase-expressing Eμ-Myc/Arf(-/-) (Cdkn2a(-/-)) mouse lymphoma cells (EL-Arf(-/-)) into C57BL/6NCrl mice intravenously. Long-term observation inside a peripheral lymph node was enabled by a novel lymph node internal window chamber technique that allows chronic, sequential lymph node imaging under in vivo physiologic conditions. Interestingly, during early stages of tumor progression we found that few if any lymphoma cells homed initially to the inguinal lymph node (ILN), despite clear evidence of lymphoma cells in the bone marrow and spleen. Unexpectedly, we detected a reproducible efflux of lymphoma cells from spleen and bone marrow, concomitant with a massive and synchronous influx of lymphoma cells into the ILN, several days after injection. We confirmed a coordinated efflux/influx of tumor cells by injecting EL-Arf(-/-) lymphoma cells directly into the spleen and observing a burst of lymphoma cells, validating that the burst originated in organs remote from the lymph nodes. Our findings argue that in NHL an efflux of tumor cells from one disease site to another, distant site in which they become established occurs in discrete bursts.
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Affiliation(s)
- Ken Ito
- Molecular Imaging Program, Department of Radiology, Stanford University, Stanford, California, USA
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Sholukh AM, Siddappa NB, Shanmuganathan V, Lakhashe SK, Rasmussen RA, Watkins JD, Vyas HK, Mukhtar MM, Hemashettar G, Thorat S, Yoon JK, Villinger F, Novembre FJ, Landucci G, Forthal DN, Ratcliffe S, Robert-Guroff M, Polonis V, Montefiori DC, Ertl HC, Ruprecht RM. Passive immunization with polyclonal anti-SHIV IgG: partial protection or increased acquisition of heterologous tier 2 SHIV – depending on IgG dose. Retrovirology 2012. [PMCID: PMC3442109 DOI: 10.1186/1742-4690-9-s2-p41] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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44
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Lee J, Nah KY, Kim RM, Oh YJ, An YS, Yoon JK, An GI, Choi TH, Cheon GJ, Soh EY, Chung WY. Effectiveness of [(124)I]-PET/CT and [(18)F]-FDG-PET/CT for localizing recurrence in patients with differentiated thyroid carcinoma. J Korean Med Sci 2012; 27:1019-26. [PMID: 22969247 PMCID: PMC3429818 DOI: 10.3346/jkms.2012.27.9.1019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 08/02/2012] [Indexed: 11/20/2022] Open
Abstract
Although the prognosis of patients with differentiated thyroid carcinoma (DTC) is generally encouraging, a diagnostic dilemma is posed when an increasing level of serum thyroglobulin (Tg) is noted, without detection of a recurrent tumor using conventional imaging tools such as the iodine-131 whole-body scanning (the [(131)I] scan) or neck ultrasonography (US). The objective of the present study was to evaluate the diagnostic value of [(124)I]-PET/CT and [(18)F]-FDG-PET/CT in terms of accurate detection of both iodine- and non-iodine-avid recurrence, compared with that of conventional imaging such as the [(131)I] scan or neck ultrasonography (US). Between July 2009 and June 2010, we prospectively studied 19 DTC patients with elevated thyroglobulin levels but who do not show pathological lesions when conventional imaging modalities are used. All involved patients had undergone total thyroidectomy and radioiodine (RI) treatment, and who had been followed-up for a mean of 13 months (range, 6-21 months) after the last RI session. Combined [(18)F]-FDG-PET/CT and [(124)I]-PET/CT data were evaluated for detecting recurrent DTC lesions in study patients and compared with those of other radiological and/or cytological investigations. Nine of 19 patients (47.4%) showed pathological [(18)F]-FDG (5/19, 26.3%) or [(124)I]-PET (4/19, 21.1%) uptake, and were classed as true-positives. Among such patients, disease management was modified in six (66.7%) and disease was restaged in seven (77.8%). In particular, the use of the described imaging combination optimized planning of surgical resection to deal with locoregional recurrence in 21.1% (4/19) of patients, who were shown to be disease-free during follow-up after surgery. Our results indicate that combination of [(18)F]-FDG-PET/CT and [(124)I]-PET/CT affords a valuable diagnostic method that can be used to make therapeutic decisions in patients with DTC who are tumor-free on conventional imaging studies but who have high Tg levels.
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Affiliation(s)
- Jandee Lee
- Department of Surgery, Eulji Medical College Hospital, Seoul, Korea
| | - Kuk Young Nah
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Ra Mi Kim
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Yeon-Ju Oh
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Young-Sil An
- Department of Nuclear Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Gwang Il An
- Department of Molecular Imaging, Korea Institute of Radiological and Medical Science, Seoul, Korea
| | - Tae Hyun Choi
- Department of Molecular Imaging, Korea Institute of Radiological and Medical Science, Seoul, Korea
| | - Gi Jeong Cheon
- Department of Molecular Imaging, Korea Institute of Radiological and Medical Science, Seoul, Korea
- Department of Nuclear Medicine, Korea University Medical Center Anam Hospital, Seoul, Korea
| | - Euy-Young Soh
- Department of Surgery, Ajou University School of Medicine, Suwon, Korea
| | - Woong Youn Chung
- Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
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Choi BH, Yoon SH, Lee S, Jo KS, Song HS, An YS, Yoon JK, Lee SJ. Primary Malignant Fibrous Histiocytoma in Mediastinum: Imaging with (18)F-FDG PET/CT. Nucl Med Mol Imaging 2012; 46:304-7. [PMID: 24900079 DOI: 10.1007/s13139-012-0157-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 07/02/2012] [Accepted: 07/05/2012] [Indexed: 11/29/2022] Open
Abstract
Malignant fibrous histiocytoma (MFH) is the most common soft tissue tumor which often occurs in the extremities and the retroperitoneum. Primary mediastinal MFH is rare; thus, findings on (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) of mediastinal MFH have not been reported yet. We report herein the case of a 64-year-old man who was presented with a superior mediastinal mass. The mass showed intense (18)F-FDG uptake with central metabolic defect on PET/CT. The maximum standardized uptake value was 17.4. After tumor removal via median sternotomy, an MFH of the storiform-pleomorphic type was diagnosed on histopathologic examination. We present the first report of (18)F-FDG PET/CT imaging of MFH in the superior mediastinum.
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Affiliation(s)
- Bong-Hoi Choi
- Clinical Research Institute, Gyeongsang National University Hospital, Chiram-dong, Jinju, Gyeongsangnam-do South Korea
| | - Seok-Ho Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
| | - Sungsoo Lee
- Department of Thoracic and Cardiovascular Surgery, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
| | - Kyung Sook Jo
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
| | - Hee-Sung Song
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
| | - Su Jin Lee
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Woncheon-dong, Yeongtong-gu, Suwon, South Korea
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Park BN, Shim W, Ahn YH, Lee JH, An YS, Yoon JK. High-dose (111)in induces g1 cell cycle arrest and cell death in rat bone marrow mesenchymal stem cells. Nucl Med Mol Imaging 2012; 46:81-8. [PMID: 24900039 DOI: 10.1007/s13139-011-0124-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2011] [Revised: 11/28/2011] [Accepted: 12/14/2011] [Indexed: 01/17/2023] Open
Abstract
PURPOSE This study was performed to evaluate the effect of (111)In-labeling on the cell growth, cycle and viability of bone marrow mesenchymal stem cells (BMSCs). METHODS Rat BMSCs were labeled with various doses of (111)In (0.4-11.1 Bq/cell). The growth curve of (111)In-BMSCs was obtained up to 14th day of labeling. The cell cycle was evaluated by 5-bromo-2-deoxyuridine (BrdU) labeling or propidium iodide (PI) staining. Senescent cells were counted under a light microscope after staining with 5-bromo-4-chloro-3-indolyl-D-galactopyranoside. Flow cytometry was performed to measure apoptotic and necrotic fractions after staining with annexin V-FITC and PI. RESULTS The growth of BMSCs labeled with higher doses of (111)In (4.4 or 11.1 Bq/cell) was significantly inhibited from the 3rd day of labeling. Flow cytometry revealed less BrdU-positive BMSCs at 11.1 Bq (111)In/cell during all measurement days and G1 arrest at 4.4 and 11.1 Bq (111)In/cell. Significant increases in apoptosis and necrosis were also observed at 4.4 (3.04%/1.35%) and 11.1 Bq (111)In/cell (9.07%/3.18%) on the 14th day (control = 1.60%/0.39%). However, no cellular senescence was visualized up to the 14th day. CONCLUSION A high dose of (111)In-labeling induced cell cycle arrest and death in BMSCs; therefore, it should be used with a careful dosimetry in case of applying it to humans.
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Affiliation(s)
- Bok-Nam Park
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, 442-749 Republic of Korea
| | - Wooyoung Shim
- Institute for Neuroregeneration and Stem Cell Research, Ajou University School of Medicine, Suwon, Republic of Korea ; Department of Molecular Science and Technology, Ajou University, Suwon, Republic of Korea
| | - Young Hwan Ahn
- Institute for Neuroregeneration and Stem Cell Research, Ajou University School of Medicine, Suwon, Republic of Korea ; Department of Neurosurgery, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Jae-Ho Lee
- Department of Biochemistry, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, 442-749 Republic of Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, Suwon, 442-749 Republic of Korea
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Kim SY, Chung YK, Kim BS, Lee SJ, Yoon JK, An YS. Resting cerebral glucose metabolism and perfusion patterns in women with posttraumatic stress disorder related to sexual assault. Psychiatry Res 2012; 201:214-7. [PMID: 22464826 DOI: 10.1016/j.pscychresns.2011.08.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 07/28/2011] [Accepted: 08/18/2011] [Indexed: 11/16/2022]
Abstract
In the literature, numerous trials using neuroimaging techniques have investigated brain function in patients with post-traumatic stress disorder (PTSD). However, the contrasting results showed that improvements, including in the study design, were required to reach consistent and convincing conclusions. This study evaluated the functional neuroimaging pattern of resting cerebral blood flow and glucose metabolism in patients with PTSD related to sexual assault. Twelve patients were enrolled for both brain single photon emission computed tomography (SPECT) and (18)F-fluorodeoxyglucose positron emission tomography (PET) investigations. All data were analyzed with statistical parametric mapping 2 (SPM2). The PTSD patients showed significant relative decreases in perfusion in the left hippocampus and in the basal ganglia compared with the control group. The PTSD group also had significantly lower cerebral glucosemetabolic activity in the left hippocampus and the superior temporal and precentral gyri than in the control group. These specific patterns of perfusion and glucose metabolism may be closely related to various neurophysiologic symptoms of PTSD.
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Affiliation(s)
- Shin-Young Kim
- Department of Psychiatry and Behavioural Sciences, Ajou University School of Medicine, Suwon, Republic of Korea
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Park BN, Shim W, Lee G, Bang OY, An YS, Yoon JK, Ahn YH. Early distribution of intravenously injected mesenchymal stem cells in rats with acute brain trauma evaluated by 99mTc-HMPAO labeling. Nucl Med Biol 2011; 38:1175-82. [DOI: 10.1016/j.nucmedbio.2011.05.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Accepted: 05/17/2011] [Indexed: 02/01/2023]
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Kim JH, Kim HY, Lee YK, Yoon YS, Xu WG, Yoon JK, Choi SE, Ko YG, Kim MJ, Lee SJ, Wang HJ, Yoon G. Involvement of mitophagy in oncogenic K-Ras-induced transformation: overcoming a cellular energy deficit from glucose deficiency. Autophagy 2011; 7:1187-98. [PMID: 21738012 DOI: 10.4161/auto.7.10.16643] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Although mitochondrial impairment has often been implicated in carcinogenesis, the mechanisms of its development in cancer remain unknown. We report here that autophagy triggered by oncogenic K-Ras mediates functional loss of mitochondria during cell transformation to overcome an energy deficit resulting from glucose deficiency. When Rat2 cells were infected with a retrovirus harboring constitutively active K-Ras (V12) , mitochondrial respiration significantly declined in parallel with the acquisition of transformation characteristics. Decreased respiration was not related to mitochondrial biogenesis but was inversely associated with the increased formation of acidic vesicles enclosing mitochondria, during which autophagy-related proteins such as Beclin 1, Atg5, LC3-II and vacuolar ATPases were induced. Interestingly, blocking autophagy with conventional inhibitors (bafilomycin A, 3-methyladenin) and siRNA-mediated knockdown of autophagy-related genes recovered respiratory protein expression and respiratory activity; JNK was involved in these phenomena as an upstream regulator. The cells transformed by K-Ras (V12) maintained cellular ATP level mainly through glycolytic ATP production without induction of GLUT1, the low Km glucose transporter. Finally, K-Ras (V12) -triggered LC3-II formation was modulated by extracellular glucose levels, and LC3-II formation increased only in hepatocellular carcinoma tissues exhibiting low glucose uptake and increased K-Ras expression. Taken together, our observations suggest that mitochondrial functional loss may be mediated by oncogenic K-Ras-induced mitophagy during early tumorigenesis even in the absence of hypoxia, and that this mitophagic process may be an important strategy to overcome the cellular energy deficit triggered by insufficient glucose.
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Affiliation(s)
- June-Hyung Kim
- Department of Biochemistry and Molecular Biology, The Graduate School, Ajou University, Suwon, South Korea
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Choi BH, Song HS, An YS, Han SU, Kim JH, Yoon JK. Relation between fluorodeoxyglucose uptake and glucose transporter-1 expression in gastric signet ring cell carcinoma. Nucl Med Mol Imaging 2010; 45:30-5. [PMID: 24899975 DOI: 10.1007/s13139-010-0058-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Accepted: 10/13/2010] [Indexed: 01/19/2023] Open
Abstract
PURPOSE Gastric signet ring cell carcinoma (GSRC) is known to have low fluorodeoxyglucose (FDG) uptake. The aim of the study was to investigate the relation between FDG uptake and glucose transporter (GLUT)-1 expression and clinicopathologic parameters in cases of GSRC. MATERIALS AND METHODS Forty patients (28 men, mean age 54 ± 12 years) with histologically confirmed GSRC who underwent pre-operative [(18)F]FDG PET/CT were enrolled. Maximum standardized uptake values (SUVmax) were compared with clinicopathologic parameters and GLUT-1 expression. Cases were divided based on GLUT-1 expression in tumor tissues into a membranous group (n = 17) and a cytoplasmic group (n = 23). RESULTS Mean SUVmax was significantly higher in the membranous group than in the cytoplasmic group (6.06 ± 2.79 vs. 3.67 ± 1.54, P = 0.03). Gastric wall invasion, depth of invasion, extent of LN metastasis, overall stage, and tumor size were found to be related to SUVmax. On the other hand, age, sex, and the presence of distant metastasis were not related to SUVmax. Multivariate analysis revealed that membranous GLUT-1 expression and the extent of LN metastasis independently predicted high FDG uptake. CONCLUSIONS This study demonstrates that high FDG uptake is mediated by membranous GLUT-1 expression in GSRC.
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Affiliation(s)
- Bong-Hoi Choi
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Wonchun-dong, Yeongtong-gu, Suwon, 443-721 Kyunggi-do Republic of Korea
| | - Hee-Sung Song
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Wonchun-dong, Yeongtong-gu, Suwon, 443-721 Kyunggi-do Republic of Korea
| | - Young-Sil An
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Wonchun-dong, Yeongtong-gu, Suwon, 443-721 Kyunggi-do Republic of Korea
| | - Sang-Uk Han
- Department of Surgery, Ajou University School of Medicine, San 5, Wonchun-dong, Yeongtong-gu, Suwon, 443-721 Kyunggi-do Republic of Korea
| | - Jang-Hee Kim
- Department of Pathology, Ajou University School of Medicine, San 5, Wonchun-dong, Yeongtong-gu, Suwon, 443-721 Kyunggi-do Republic of Korea
| | - Joon-Kee Yoon
- Department of Nuclear Medicine and Molecular Imaging, Ajou University School of Medicine, San 5, Wonchun-dong, Yeongtong-gu, Suwon, 443-721 Kyunggi-do Republic of Korea
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