No abstract available.
Electrons* ; Positron-Emission Tomography*

Positron Emission Tomography(PET) is a new imaging modality to make biochemical metabolic images. Because biochemical changes precede anatomical changes in most of diseases including cancer, PET can detect earlier changes of diseases than conventional anatomical imaging modalities. PET can also characterize biochemical property of diseases. A PET center is composed of a medical cyclotron, synthesis system of radiopharmaceuticals and scanner. For PET oncology, several positron-emitting radiopharmaceuticals have been developed. Among them, F-18-fluorodeoxyglucose (FDG) is most frequently used. Higher rate of glucose metabolism has been observed in cancer cells. Like glucose, FDG is transported into the cancer cells and converted to FDG-6-phosphate by hexokinase. FDG-6-phosphate is trapped in the cytoplasm, and emits gamma rays to make PET images. The current application of FDG PET in oncology is in detection, differentiation, and staging of the primary tumors, grading malignancy, monitoring therapeutic response, and early detection of recurrence. Nowadays, PET is an established procedure for staging the diseases and detecting the recurrence in many cancers, especially the lung, colorectal, and head and neck cancers, melanoma, and lymphoma. PET is a regular part of medical insurance reimbursement in many developed countries, and becomes a valuable research tool in oncology as well as an important imaging modality in managing cancer patients.
Cyclotrons ; Cytoplasm ; Developed Countries ; Electrons* ; Gamma Rays ; Glucose ; Head ; Hexokinase ; Humans ; Insurance ; Lung ; Lymphoma ; Melanoma ; Metabolism ; Neck ; Radiopharmaceuticals ; Recurrence

No abstract available.
Brain Neoplasms* ; Brain*

No abstract available.
Brain Neoplasms* ; Brain*

Cancer cells are known to show increased rates of glycolysis metabolism. Based on this, PET studies using F-18-fluorodeoxyglucose have been used for the detection of primary and metastatic tumors. To account for this increased glucose uptake, a variety of mechanisms has been proposed. Glucose influx across the cell membrane is mediated by a family of structurally related proteins known as glucose transporters (Gluts). Among 6 isoforms of Gluts, Glut-1 and/or Glut-3 have been reported to show increased expression in various tumors. Increased level of Glut mRNA transcription is supposed to be the basic mechanism of Glut overexpression at the protein level. Some oncogens such as src or ras intensely stimulate Glut-1 by means of increased Glut-1 mRNA levels. Hexokinase activity is another important factor in glucose uptake in cancer cells. Especially hexokinase type II is considered to be involved in glycolysis of cancer cells. Much of the hexokinase of tumor cells is bound to outer membrane of mitochondria by the porin, a hexokinase receptor. Through this interaction, hexokinase may gain preferred access to ATP synthesized via oxidative phosphorylation in the inner mitochondria compartment. Other biologic factors such as tumor blood flow, blood volume, hypoxia, and infiltrating cells in tumor tissue are involved. Relative hypoxia may activate the anaerobic glycolytic pathway. Surrounding macrophages and newly formed granulation tisssue in tumor showed greater glucose uptake than did viable cancer cells. To expand the application of FDG PET in oncology, it is important for nuclear medicine physicians to understand the related mechanisms of glucose uptake in cancer tissue.
Adenosine Triphosphate ; Anoxia ; Biological Factors ; Blood Volume ; Carcinogens ; Cell Membrane ; Glucose* ; Glycolysis ; Hexokinase ; Humans ; Macrophages ; Membranes ; Metabolism ; Mitochondria ; Nuclear Medicine ; Oxidative Phosphorylation ; Protein Isoforms ; RNA, Messenger

No abstract available.
Thyroid Gland* ; Thyroid Neoplasms*

PURPOSE: We investigated reproducibility of the quantification of left ventricular volume and ejection fraction, and grading of myocardial wall motion and systolic thickening when we used gated myocardial SPECT and Cedars quantification software. MATERIALS AND METHODS: We performed gated myocardial SPECT in 33 consecutive patients twice in the same position after Tc-99m-MIBI SPECT. We used 16 frames per cycle for the gatingof sequential Tc-99m-MTBI SPECT. After reconstruction, we used Cedars quantitative gated SPECT and calculated ventricular volume and ejection fraction (EF), Wall motion was graded using 5 point score. Wall thickening was graded using 4 point score. Coefficient of variation for re-examination of volume and fraction were calculated. Kappa values (k-value) for assessing reproducibility of wall motion or wall thickening were calculated. RESULTS: Enddiastolic volumes (EDV) ranged from 58 mi to 248 ml (122 ml +/- 42 ml), endsystolic volumes (ESV) from 20 mi to 174 mi (65 ml +1- 39 ml), and EF from 20% to 68% (51% +/- 14%). Geometric mean of standard deviations of 33 patients was 5.0 ml for EDV, 3.9 ml for ESV and 1.9% for EF. Their average differences were not different from zero (p>0.05). k-value for wall motion using 2 consecutive images was 0.76 (confidence interval: 0.71-0.81). k-value was 0.87 (confidence interval:0.83-0.90) for assessment of wall thickening. CONCLUSION: We concluded that quantification of functional indices, assessment of wall motion and wall thickening using gated Tc-99m-MIBI SPECT was reproducible and we could use this method for the evaluation of short-acting drug effect.
Heart ; Humans ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. MATERIALS AND METHODS: 118 patients (M: F=66:52, 62.7+/-10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-201/stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods (14.6+/-5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. RESULTS: Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted` out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. CONCLUSION:: We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.
Death ; Electrocardiography ; Heart Failure ; Humans ; Multivariate Analysis ; Myocardial Infarction ; Myocardial Ischemia ; Perfusion ; Perioperative Period ; Retrospective Studies ; Risk Factors ; Tomography, Emission-Computed, Single-Photon*

PURPOSE: For the purpose of using Re-188 as a therapeutic radionuclide, we performed the quality control of the W-188/Re-188 generation system. MATERIALS AND METHODS: Several quality control tests of the Re-188 eluate from generator were carried out of about 300 days. After elution of Re-188 with normal saline (20 ml), chromatogram and gamma-ray spectrum of Re-188 eluate were obtained. The presence of aluminum which was derived from the elumina bed of the generator was detected by using aluminum ion indicator kit. Re-188 eluate was allowed to decay for several days, and then W-188 breakthrough in the Re-188 eluate was measured by detecting gamma-ray at 227 keV and 290 keV. The pH and the pyrogenicity of the eluate were checked. The Re-188 eluate from the generator was 67.4+/-7.0% of W-188 during 270 days, and it was hightest at third day after previous elution. Radiochemical purity of Re-188 eluate obtained from chromatogram was higher than 99%. Gamma-ray spectrum of Re-188 eluate showed a peak at 155 keV. Aluminum ion and W-188 contamination were not detected. The pH of Re-188 eluate was 3 and the concentration yield was 85%. CONCLUSION: Our experiments and results on quality control tests of Re-188 eluate from W-188/Re-188 generator may be useful for setting W-188/Re-188 generator in hospitals.
Aluminum ; Hydrogen-Ion Concentration ; Quality Control*

PURPOSE: For the purpose of using Re-188 as a therapeutic radionuclide, we performed the quality control of the W-188/Re-188 generation system. MATERIALS AND METHODS: Several quality control tests of the Re-188 eluate from generator were carried out of about 300 days. After elution of Re-188 with normal saline (20 ml), chromatogram and gamma-ray spectrum of Re-188 eluate were obtained. The presence of aluminum which was derived from the elumina bed of the generator was detected by using aluminum ion indicator kit. Re-188 eluate was allowed to decay for several days, and then W-188 breakthrough in the Re-188 eluate was measured by detecting gamma-ray at 227 keV and 290 keV. The pH and the pyrogenicity of the eluate were checked. The Re-188 eluate from the generator was 67.4+/-7.0% of W-188 during 270 days, and it was hightest at third day after previous elution. Radiochemical purity of Re-188 eluate obtained from chromatogram was higher than 99%. Gamma-ray spectrum of Re-188 eluate showed a peak at 155 keV. Aluminum ion and W-188 contamination were not detected. The pH of Re-188 eluate was 3 and the concentration yield was 85%. CONCLUSION: Our experiments and results on quality control tests of Re-188 eluate from W-188/Re-188 generator may be useful for setting W-188/Re-188 generator in hospitals.
Aluminum ; Hydrogen-Ion Concentration ; Quality Control*