Radioiodine ablation therapy has been considered to be a standard treatment for patient with differentiated thyroid cancer after total thyroidectomy. Patients may need to be hospitalized to reduce radiation exposure of other people and relatives from radioactive patients receiving radioiodine therapy. Medical staffs, nursing staffs and technologists sometimes hesitate to contact patients in radioiodine therapy ward. The purpose of this paper is to introduce radiation dosimetry, estimate radiation dose from patients and emphasize the safety of radiation exposure from patients treated with high dose radioiodine in therapy ward. The major component of radiation dose from patient is external exposure. However external radiation dose from these patients treated with typical therapeutic dose of 4 to 8 GBq have a very low risk of cancer induction compared with other various risks occurring in daily life. The typical annual radiation dose without shielding received by patient is estimated to be 5 to 10 mSv, which is comparable with 100 to 200 times effective dose received by chest PA examination. Therefore, when we should keep in mind the general principle of radiation protection, the risks of radiation exposure from patients are low and the medical personnel are considered to be safe from radiation exposure.
Humans ; Medical Staff ; Nursing Staff ; Radiation Protection ; Radiometry ; Thorax ; Thyroid Neoplasms ; Thyroidectomy

During the three years from March, 1983 to Feb, 1986, 159 cases of head injury surgically treated in the department of neurosurgery, Capital Armed Forces General Hospital were clinicostatistically analysed and discussed with the review of the literature. The following results were obtained.1) Due to the army distinctiveness, all cases were male and the age incidence was becoming maximal at the third decade. 2) Traffic accidents form by far the largest Group(38.4%), and next are, in order of incidence, accidents due to fall from height, simple fall(19%), exercise(12.6%), gun shot wound or explosive injury(9.4%) and assault(9.4%). 3) Skull fracture were seen in 115 cases(72.3%), and nearly half of those 55 cases, were linear fracture. 4) Of the 133 patients with intracranial hematoma or subdural hygroma, 88 cases(66.7%) were accompanied by skull fracture. 93% of epidural hematomas were associated with skull fracture and the most common wite of hematoma was temporoparietal area. 5) Of all cases of subdural hematoma, acute type was prevalent(59.4%) and its main site involved was temporoparietal area. 6) The associated injuries were found in 22.6% of patients. The frequent ones were facial bone fracture, upper extremity fracture, clavicle fracture, and chest injury, in order. 7) The minor head injury of Glasgow coma scale score(GCS) of 13 to 15 was 68 cases(42.8%). The moderated head injury of 9 to 12 was 28 cases(17.6) and the serve head injury of 3 to 8, 63 cases(39.1%). 8) The operation mortality was 26.8% and the good recovery was achieved 55.4% of patients. The remaining 18.8% resulted in disabled or vegetative state. 9) In the accidents of gun shot wound or explosive injury, operation mortality rate was 60%, but 5 cases(33.3%) were seen good recovery.
Accidents, Traffic ; Arm ; Clavicle ; Craniocerebral Trauma* ; Facial Bones ; Glasgow Coma Scale ; Head* ; Hematoma ; Hematoma, Subdural, Acute ; Hospitals, General ; Humans ; Incidence ; Male ; Military Personnel* ; Mortality ; Neurosurgery ; Persistent Vegetative State ; Skull Fractures ; Subdural Effusion ; Thoracic Injuries ; Upper Extremity ; Wounds and Injuries

A 50-yr-old man presented with intermittent hemoptysis and was diagnosed small cell lung cancer. 18F-FDG PET/CT for staging demonstrated extensive hypermetabolic lesions throughout the skeleton and liver. Interestingly, skeletal muscles of limbs, mediastinum, bowel, and especially brain showed very low FDG uptake. Because of some characteristics in common with super scan on skeletal scintigraphy, this case could be considered as 'metabolic super scan'.
Carcinoma, Small Cell/complications/radionuclide imaging ; Fluorine Radioisotopes/diagnostic use ; Fluorodeoxyglucose F18/*diagnostic use ; Hemoptysis/complications/radionuclide imaging ; Humans ; Liver Neoplasms/diagnosis/secondary ; Lung Neoplasms/complications/radionuclide imaging ; Male ; Middle Aged ; *Positron-Emission Tomography ; Radiopharmaceuticals/*diagnostic use

The purpose of this study was to evaluate the value of fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) for detecting the recurrence of gastric cancer. We performed a retrospective review of 139 consecutive patients who underwent PET/CT and contrast-enhanced abdominal CT (CECT) for surveillance of gastric cancer after curative resection. Recurrence of gastric cancer was validated by histopathologic examination for local recurrence or serial imaging study follow-up with at least 1 yr interval for recurrence of distant metastasis form. Twenty-eight patients (20.1%) were confirmed as recurrence. On the patient based analysis, there was no statistically significant difference in the sensitivity, specificity and accuracy of PET/CT (53.6%, 84.7%, and 78.4%, respectively) and those of CECT (64.3%, 86.5%, and 82.0%, respectively) for detecting tumor recurrence except in detection of peritoneal carcinomatosis. Among 36 recurrent lesions, 8 lesions (22.2%) were detected only on PET/CT, and 10 lesions (27.8%) only on CECT. PET/CT had detected secondary malignancy in 8 patients. PET/CT is as accurate as CECT in detection of gastric cancer recurrence after curative resection, excepting detection of peritoneal carcinomatosis. Moreover, additional PET/CT on CECT could improve detection rate of tumor recurrence and provide other critical information such as unexpected secondary malignancy.
Aged ; Female ; Fluorodeoxyglucose F18/*diagnostic use ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/*diagnosis/radiography/radionuclide imaging ; Positron-Emission Tomography/*methods ; Radiopharmaceuticals/*diagnostic use ; Retrospective Studies ; Sensitivity and Specificity ; Stomach Neoplasms/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed/*methods

Soft tissue uptake of Tc-99m labeled bone seeking agents, such as Tc-99m 3,3-diphosphono-1,2-propanedicarboxylic acid (DPD), is commonly seen in clinical practice, even though bone scintigraphy is mainly used to detect bone disease. However, gastric uptake of bone agents in patients with gastric cancer is very rare. And it has been reported that calcified gastric adenocarcinoma appears in only about 5% of all gastric cancer. We report a rare case of bone scintigraphy, single photon emission computed tomography and computed tomography fusion images that demonstrated diffuse gastric uptake of Tc-99m DPD in a patient with advanced gastric cancer.
Stomach Neoplasms/*metabolism ; Stomach/*metabolism ; Radiopharmaceuticals/*pharmacokinetics ; Organotechnetium Compounds/diagnostic use/*pharmacokinetics ; Male ; Humans ; Diphosphonates/diagnostic use/*pharmacokinetics ; Bone and Bones/*radionuclide imaging ; Aged

In this paper, the authors intended to summarize briefly the features of lymphoma with regard to (18)F-FDG PET for assessment of tumor response to therapy, to describe why assessment of treatment response should be performed, to review what method so far has been used in monitoring treatment response, to discuss what limitations of morphologic imaging criteria for assessing tumor response are, in compared with (18)F-FDG PET, and to introduce recently proposed criteria for assessing tumor response in malignant lymphoma. And also the authors emphasize the need to understand the characteristics of diagnostic performance of (18)F-FDG PET in several clinical settings in order to interpret (18)F-FDG PET results appropriately, and to encourage the use of interval likelihood ratio to enhance clinical implications of test results which, in turns, allows referring physicians to understand the meaning of interpretation with easy. Until recently, treatment response has been assessed according to the morphologic criteria. Metabolic imaging with (18)F-FDG PET was adopted to have important role for treatment assessment in IWC+PET criteria proposed recently by IHP. To accomplish this role, we should perform and interpret (18)F-FDG PET according to IWC+PET criteria. It is important for referring physicians to understand the various limitations of (18)F-FDG PET and pitfalls in PET interpretation, and to understand that clinical information are needed by nuclear medicine physicians to optimize the interpretation of (18)F-FDG PET.
Lymphoma ; Nuclear Medicine ; Positron-Emission Tomography

PURPOSE: In prior study, we synthesized 99mTc-galactosylated chitosan (GC) and performed in vivo biodistribution study, showed specific targeting to hepatocyte. The aim of this study is to evaluate the labeling efficiency and cytotoxicity of modified galactosylated chitosan compounds, galactosyl methylated chitosan (GMC) and HYNIC-galactosylated chitosan (GCH). MATERIALS AND METHODS: GC, GMC and GCH were synthesized and radiolabeled with 99mTc. Then, they were incubated for 6 hours at room temperature and human serum at 37 degrees C. Labeling efficiencies were determined at 15, 30 m, 1, 2, 3 and 6 h after radiolabeling. To evaluate cytotoxicity, MTT assay was performed in HeLa and HepG2 cells. RESULTS: In comparison with them of 99mTc-GC, labeling efficiencies of 99mTc-GMC were significantly improved (100, 97 and 89% in acetone and 96.3, 95.8 and 75.6% in saline at 15 m, 1 and 6 h, respectively). Moreover, 99mTc-GCH showed more improved labeling efficiencies (> 95% in acetone and human serum and > 90% in saline at 6 h). In MTT assay, cytotoxicity was very low and not different from that of controls. CONCLUSION: These results represent that these compounds are radiochemically compatible radiopharmaceuticals, can be used in hepatocyte specific imaging study and in vivo gene or drug delivery monitoring.
Acetone ; Chitosan* ; Hep G2 Cells ; Hepatocytes ; Humans ; Radiopharmaceuticals

PURPOSE: This study was performed to investigate the clinical significance of reverse redistribution (RR) phenomenon detected on delayed Tc-99m tetrofosmin myocardial single photon emission computed tomography (SPECT) in patients with acute myocardial infarction after revascularization. MATERIALS AND METHODS: A Tc-99m tetrofrosmin myocardial SPECT was performed in 67 consecutive patients after revascularization for acute myocardial infarction. Myocardial SPECT imaging was performed for early imaging at 40 min and for delayed imaging at 180 min after reinjection at myocardial stress. Regional myocardial uptakes were scored by 4-point scoring in the left ventricular wall divided into 17 segments. Reverse redistribution was defined as an increase of more than 2 point in the activity score on the delayed image. Follow-up myocardial SPECT and coronary angiography (CAG) were performed 9 months later. RESULTS: On myocardial SPECT performed following revascularization, RR was observed in 100 of all 319 segments (31%) and in 43 patients (64%). The abnormalities of perfusion and regional wall motion were more severe in the patients with RR compared to those without RR (p<0.05). On follow-up myocardial SPECT, the myocardial perfusion, regional wall motion, and myocardial thickness were significantly improved in the patients with RR (p<0.05) however, these changes were not significant in those without RR. There was no significant difference between the patients with RR and those without RR in the occurrence of restenosis on CAG. CONCLUSIONS: In patients with acute myocardial infarction, the regions showing the RR phenomenon on delayed Tc-99m tetrofosmin SPECT may reflect viable myocardium and indicate recovery of salvaged myocardium.
Angioplasty ; Coronary Angiography ; Follow-Up Studies ; Humans ; Myocardial Infarction ; Myocardial Perfusion Imaging ; Myocardium ; Perfusion ; Tomography, Emission-Computed, Single-Photon

F-18 fluorodeoxyglucose (FDG) is a highly influential radiotracer that provides valuable information in many cancer types. However, the normal biodistribution of F-18 FDG is often variable and can be altered by intrinsic or iatrogenic factors. We report a case of diffuse symmetrically increased skeletal muscle uptake and relatively decreased hepatic uptake on F-18 FDG PET/CT in a 57-year-old female with pulmonary adenocarcinoma. Detailed clinical evaluation and retrospective radiologic evaluation revealed that she had been diagnosed with subacute thyroiditis 2 weeks ago. After 6 weeks, F-18 FDG distribution was normalized at the follow-up PET/CT study.

PURPOSE: We developed a Tc-99m and fluorescence-labeled peptide, Tc-99m TAMRA-GHEG-ECG-GNQWFI, to target tumor cells, and evaluated the diagnostic performance as a dual-modality imaging agent for tumor in a murine model. METHODS: TAMRA-GHEG-ECG-GNQWFI was synthesized using Fmoc solid-phase peptide synthesis. Radiolabeling of TAMRA-GHEG-ECG-GNQWFI with Tc-99m was done using ligand exchange via tartrate. Binding affinity and in vitro cellular uptake studies were performed. Gamma camera imaging, biodistribution, and ex vivo imaging studies were performed in murine models with U87MG tumors. Tumor tissue slides were prepared and analyzed with immunohistochemistry using confocal microscopy. RESULTS: After radiolabeling procedures with Tc-99m, Tc-99m TAMRA-GHEG-ECG-GNQWFI complexes were prepared in high yield (> 95%). The K(d) of Tc-99m TAMRA-GHEG-ECG-GNQWFI determined by saturation binding was 29.5 ± 4.5 nM. Confocal microscopy images of U87MG cells incubated with TAMRA-GHEG-ECG-GNQWFI showed strong fluorescence in the cytoplasm. Gamma camera imaging revealed substantial uptake of Tc-99m TAMRA-GHEG-ECG-GNQWFI in tumors. Tumor uptake was effectively blocked by the co-injection of an excess concentration of GNQWFI. Specific uptake of Tc-99m TAMRA-GHEG-ECG-GNQWFI was assessed by biodistribution, ex vivo imaging, and immunohistochemistry stain studies. CONCLUSION In vivo and in vitro studies revealed substantial and specific uptake of Tc-99m TAMRA-GHEG-ECG-GNQWFI in tumor cells. Tc-99m TAMRA-GHEG-ECG-GNQWFI could be a good candidate dual-modality imaging agent for tumors.