PURPOSE: We evaluated the usefulness of Re-188 sulfur colloid for radiation synovectomy and therapy of intraperitoneal metastasis. MATERIALS AND METHODS: We investigated the labeling efficiency of Re-188 sulfur colloid on various conditions. The stability of Re-188 sulfur colloid was observed at room temperature for 24 h and in human serum and synovial fluid for 72 h. The particle size distribution of Re-188 sulfur colloid was rneasured by filtering with various pore size filters. Animal experiment was performed in mice and rabbits. RESULTS: The labeling efficiency of Re-188 sulfur colloid was 64,5+/-5.8% (n=5) at the conditions of sodium thiosulfate 40 mg, EDTA Na2.2H2O 0,8 mg, KReO4 0.8 mg at pH l. After purification, the radiochemical purity was higher than 99%. The stability of Re-188 sulfur colloid was high (>99%) at room temperature for 24 h and in human serum and synovial fluid for 72 h. The particle size distribution of Re-188 sulfur colloid was 0.3% (<1 micrometer), 11.2% (1~5 micrometer), 35.8% (5~10 micrometer) and 52.8% (>10 micrometer). In mice, 1 h postinjection of Re-188 sulfur colloid into tail vein, uptakes in lung, liver and muscle were 37.30+/-5.36, 32.33+/-5.79, 6.60+/-0.02% 1D/organ respectively. After I.p. injection in rnice, the uptakes of extraperitonial organs of Re-188 sulfur colloid at 1 and 24 h were 0.1+/-0.1, 0.4+/-0.1% ID/organ, and the excretions through urine and feces (~70 h) were low (2.68+/-0.80, 0.95+/-0.17%). When Re-188 sulfur colloid was injected to synovial space of rabbit, the uptake in other organs except knee was very low. CONCLUSION: Re-188 sulfur colloid showed high labeling efficiency, stability and potency for clinical use.
Animal Experimentation ; Animals ; Colloids* ; Edetic Acid ; Feces ; Humans ; Hydrogen-Ion Concentration ; Knee ; Liver ; Lung ; Mice ; Neoplasm Metastasis ; Particle Size ; Rabbits ; Sodium ; Sulfur ; Synovial Fluid ; Veins

PURPOSE: Cross-modality coregistration of positron emission tomography (PET) and magnetic resonance imaging (MR) could enhance the clinical information. In this study we propose a refined technique to improve the robustness of registration, and to implement more realistic visualization of the coregistered images. MATERIALS AND METHODS: Using the sinogram of PET emission scan, we extracted the robust head boundary and used boundary-enhanced PET to coregister PET with MR. The pixels having 10% of maximum pixel value were considered as the boundary of sinogram. Boundary pixel values were exchanged with maximum value of sinogram. One hundred eighty boundary points were extracted at intervals of about 2 degree using simple threshold method from each slice of MR images. Best affined transformation between the two point sets was performed using least square fitting which should minimize the sum of Euclidean distance between the point sets. We reduced calculation time using pre-defined distance map. Finally we developed an automatic coregistration program using this boundary detection and surface matching technique. We designed a new weighted normalization technique to display the coregistered PET and MR images simultaneously. RESULTS: Using our newly developed method, robust extraction of head boundary was possible and spatial regishation was successfully performed. Mean displacement error was less than 2.0mm. In visualization of coregistered images using weighted normalization method, structures shown in MR image could be realistically represented. CONCLUSION: Our refined technique could practically enhance the performance of automated three dimensional coregistration.
Brain* ; Head ; Magnetic Resonance Imaging ; Positron-Emission Tomography

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: The purpose of this study was to evaluate the phenomenon of diaschisis in the cerebellum and cerebral certex in patients with pure basal ganglia hemorrhage using cerebral blood flow SPECT. MATERIALS AND METHODS: Twelve patients with pure basal ganglia hemorrhage were studied with Tc-99m ECD brain SPECT Asymmetric index (AI) was calculated in the cerebellum and cerebral cortical regions as |CR-CL|/(CR-CL)x200, where CR and GL and the mean reconstructed counts for the right and left ROIs, respectively. Hypoperfusion was considered to be present when AI was greater than mean+2 SD of 20 control subjects. RESULTS: Mean AI of the cerebellum and cerebral cortical regions in patients with pure basal ganglia hemorrhage was significantly higher than normal controls (p<0.05): Cerebellum (18.68+/-8.94 vs 4.35+/-0.94, mean+/-SD), thalamus (31.91+/-10.61 vs 2.57+/-1.45), basal ganglia (35.94+/-16.15 vs 4.34+/-2.08), parietal (18.94+/-10.69 vs 3.24+/-0.87), frontal (13.60+/-10.8 vs 4.02+/-2.04) and temporal cortex (18.92+/-11.95 vs 5.13+/-1.69). Ten of the 12 patients had significant hypoperfusion in the contralateral cerebellum. Hypoperfusion was also shown in the ipsilateral thalamus (n=12), ipsilateral parietal (n=12), frontal (n=6) and temporal cortex (n=10). CONCLUSION: Crossed cerebellar diaschisis (CCD) and cortical diaschisis may frequently occur in patients with pure basal ganglia hemorrhage, suggesting that CCD can develop without the interruption of corticopontocerebellar pathway.
Basal Ganglia Hemorrhage* ; Basal Ganglia* ; Brain ; Cerebellum ; Humans ; Rabeprazole ; Thalamus ; Tomography, Emission-Computed, Single-Photon

No abstract available.
Parathyroid Neoplasms*

Temporomandibular (TM) joint pain results from many etiologic factors. The aim of this study was to evaluate the utility of Bone SPECT in patients with TM joint pain. The subjects were 34 patients with TM joint pain. All patients underwent plain radiography, planar bone scan, and Bone SPECT. The intensity of radioisotope uptake at TM joint was graded into three; no increased uptake above three background activity as grade 0, uptake similar to occipital bone as grade I, and uptake similar to maxillary sinus as grade II. Clinical findings and therapeutic methods were reviewed. Twenty-seven patients (80%) out of 34 patients with TM joint pain had increased uptake in bone SPECT. Twenty-one (78%) out of 27 patients had increased uptake in the mandibular condyle and remaining six patients (22%) had uptake in the mandibular and maxillary arch, which proved to be dental problem. Seven patients out of 34 were grade as 0, four (12%) were grade I, 23 (68%) were grade II. Four patients with grade I had clicking sound and symptoms which were subsided with medication in all cases. Among 23 patients with grade II, 7 patients had clicking sound and 14 patients underwent medication and decompression therapy. With Planar bone scan, 11 cases (32%) had increased uptake in TM joint area. Plain radiography revealed narrowing, distension, erosion and limitation of TM joint in 16 cases (47%). Bone SPECT can be valuable for screening and managing the patients with TM joint pain. Patients with grade II needed intensive treatment such as joint aspiration. However degree of the radioisotope uptake did not well correlated with clinical symptoms.
Arthralgia ; Decompression ; Humans ; Joints ; Mandibular Condyle ; Mass Screening ; Maxillary Sinus ; Occipital Bone ; Radiography ; Temporomandibular Joint* ; Tomography, Emission-Computed, Single-Photon*

Cancer tissues are characterized by increased glucose uptake. 18F-fluorodeoxyglucose(FDG), a glucose analogue is used for the diagnosis of cancer in PET studies. This study was aimed to compare the glucose uptake and glucose transporter l(GLUT1) expression in various human colon cancer cells. We measured FDG uptake by cell retention study and expression of GLUTI using Western blotting. Human colon cancer cells, SNU-C2A, SNU-C4 and SNU-C5, were used. The cells were incubated with 1micro Ci/ml of FDG in HEPES-buffered saline for one hour. The FDG uptake of SNU-C2A,SNU-C4 and SNU-C5 were 16.8+/-1.36, 12.3+/-5.55 and 61.0+/-2.17cpm/microgram of protein, respectively. Dose-response and time-course studies represent that FDG uptake of cancer cells were dose dependent and time dependent. The rate of FDG uptake of SNU-C2A, SNU-C4 and SNU-C5 were 0.29+/-0.03, 0.21+/-0.09 and 1.07+/-0.07cpm/min/microgram of protein, respectively. Western blot analysis showed that the GLUT1 expression of SNU-C5 was significantly higher than those of SNU-C2A and SNU-C4. These results represent that FDG uptake into human colon cancer cells are different from each other. In addition, FDG uptake and expression of CLUT1 are closely related in human colon cancer cells.
Blotting, Western ; Colon* ; Colonic Neoplasms* ; Diagnosis ; Glucose ; Glucose Transport Proteins, Facilitative ; Humans*

he purpose of this study was to evaluate the usefulness of whole body F-18 FDG PET scan for deceting postoperative recurrence of cancer. One hundred four cancer patients after operation were enrolled(l4 brain tumor, 15 head and neck cancer, 23 gynecologic cancer). Besides conventional images(CI) including CT and MRI, F-18 FDG PET scan was obtained on ECAT EXACT 47 scanner(Siemens-CTI), beginning 60 minutes after injection of 370MBq(10mCi) of F-18 FDG. Regional scan was also obtained with emission image. Transmission images using Ge-68 were carried out for attenuation correction in both whole body and regional images. Findings of PET and CI were confirmed by pathology or clinical follow up. The sensitivity and specificity of PET for detecting recurrence were 94% and 92%, respectively. Contrarily, the sensitivity and specific it of CI were 78% and 68% CI results were negative and PET results were positive in 11 cases. The biopsy or clinical follow-up of those cases confirmed recurrence of tumor. False negative cases of CI were frequent in patients with gynecologic cancers. Also we measured the Serum concentration of tumor markers in patients with gynecologic cancer(CA125), thyroid cancer(thyroglobulin), and colorectal cancer(CEA). The sensitivity and specificity of tumor markers were 71% and 84%, respectively. We conclude that F-18 FDG PET can be used valuably in detecting recurrent foci of a wide variety of malignancy compared to conventional diagnositic methods.
Biopsy ; Brain Neoplasms ; Follow-Up Studies ; Head and Neck Neoplasms ; Humans ; Magnetic Resonance Imaging ; Pathology ; Positron-Emission Tomography ; Recurrence* ; Sensitivity and Specificity ; Thyroid Gland ; Biomarkers, Tumor

To evaluate the clinical utility of Tc-99m MIBI scan in the detection of residual thyroid tissue or metastatic lesion in postoperative thyroid cancer patients, we compared Tc-99m MIBI scan with I-131 diagnostic and therapeutic scan in 30 postoperative well-differentiated thyroid cancer patients. Thyroglobulin levels of both on and off thyroid hormone medication and antithyroglobulin antibody were tested [Tg(on), Tg(off)l Positive rates for I-131 diagnostic and Tc-99m MIBI scan were 81% and 68% respectively. Concordance between I-131 diagnostic and Tc-99m MIBI scan was observed in 15 cases; 12 positive and 3 negative respectively Among the 6 cases with negative I-131 diagnostic scan and positive Tc-99m MIBI scan, 4 were positive in the therapeutic I-131 scan. We concluded that Tc-99m MIBI scan maybe a useful complementary modality to the currently established method of I131 scan and serum thyroglobulin level in the detection of recurrent or metastatic thyroid cancer, especially in the case of negative I-131 diagnostic scan.
Follow-Up Studies* ; Humans ; Thyroglobulin ; Thyroid Gland* ; Thyroid Neoplasms*

To evaluate the utility of I-131, T1-201 scintigraphy, and serum thyroglobulin(Tg) in the follow-up of differentiated thyroid cancer, we compared retrospectively the data from 33 patients who underwent total or subtotal thyroidectomy. I-131 scintigraphy was performed after optimal endogenous TSH stimulation (TSH>50microgram/ml). Total 41 cases of I-l3l and T1-201 scintigraphy pairs were examined. Concomitant serum thyroglobulin levels were measured for 41 pairs of scan. Tg-off levels(that measured after discontinuation of the thyroid hormone) higher than 40ng/ml were considered positive, and Tg-on levels(that measured during the thyroid hormone replacement) higher than 5ng/ml were considered positive. The concordance rates between I-131 therapeutic scintigraphy and T1-201 scintigraphy was 48% in the 38 case of total scan pairs(59% in the 17 cases of postoperative preablation group, and 38% in the 21 cases of postoperative postablation group), Of 17 studies before the I-131 ablation therapy (preablation group), 7 showed positive I-131 therapeutic scintigraphy despite of negative T1-201 scintigraphy. Among patients with negative I-131 therapeutic scintigraphy, no patients had abnormal T1-201 uptake. However, of 21 studies which were done after radioiodine therapy(postablation group) 6 had abnormal uptake on T1-201 scintigraphy which were not seen on I-131 therapeutic scintigraphy, and Tg-off levels also elevated in this 4 of 6 cases. As a result, I-131 therapeutic scintigraphy showed highest positive rate at postoperative preablation follow-up study in differentiated thyroid cancer patients. T1-201 scintigraphy may be useful in postablation studies, and the use of the combined modalities(T1-201 and Tg levels) provides a higher diagnostic yield.
Follow-Up Studies* ; Humans ; Radionuclide Imaging* ; Retrospective Studies ; Thyroglobulin* ; Thyroid Gland* ; Thyroid Neoplasms* ; Thyroidectomy