2.A Giant Hepatic Hemangioma Complicated by Kasabach-Merritt Syndrome: Findings of Tc-99m RBC Scintigraphy and SPECT Including a Total Body Blood Pool Imaging Study.
Myung Hee SOHN ; Hwan Jeong JEONG ; Seok Tae LIM ; Dong Wook KIM ; Chang Yeol YIM
Nuclear Medicine and Molecular Imaging 2009;43(1):83-86
Kasabach-Merritt syndrome (KMS) consists of thrombocytopenia, microangiopathic hemolytic anemia, and localized consumption coagulopathy that develops within vascular hemangioma. This syndrome may also be associated with occult hemangiomas located at various sites. Tc-99m RBC scintigraphy and SPECT have proven to be reliable for confirming or excluding hemangioma. Total body blood pool imaging study during the scintigraphy also provides a means of screening for occult lesions. The authors report the case of a 29-year-old man who presented with a giant hepatic hemangioma complicated by KMS, and underwent Tc-99m RBC scintigraphy and SPECT including a total body blood pool imaging study.
Adult
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Anemia, Hemolytic
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Disseminated Intravascular Coagulation
;
Hemangioma
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Humans
;
Kasabach-Merritt Syndrome
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Mass Screening
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Thrombocytopenia
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Tomography, Emission-Computed, Single-Photon
3.A Case of Patella Metastasis of Papillary Thyroid Carcinoma.
Eun Ji HAN ; Woo Hee CHOI ; Yong An CHUNG ; Hyung Sun SOHN ; Chang Suk KANG
Nuclear Medicine and Molecular Imaging 2009;43(1):79-82
A 73-year-old man presented with a chief complaint of progressive left knee pain for two months. He had a history of total thyroidectomy and central lymph node dissection due to papillary thyroid carcinoma three months ago. MRI images revealed a solid mass in the left patella. A solid mass demonstrated low signal on T1 weighed image, and high signal on T2 weighed image. And whole body bone scan showed focal photon defect in same lesion of left patella. The histologic result of left knee lesion was adenocarcinoma, consistent with metastatic papillary thyroid carcinoma. Although patellar metastasis of papillary thyroid carcinoma is very rare, when knee pain and radiologic abnormality are noted, differential diagnosis of metastasis is necessary.
Adenocarcinoma
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Aged
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Carcinoma
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Diagnosis, Differential
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Humans
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Knee
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Lymph Node Excision
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Neoplasm Metastasis
;
Patella
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Thyroid Gland
;
Thyroid Neoplasms
;
Thyroidectomy
4.Bone Mineral Density Measurement of Rats Using Dual-energy X-ray Absorptiometry: Precision of In Vivo Measurements for Various Skeletal Sites with or without Repositioning.
Dong Hyun OH ; Jae Ho JUNG ; Sang Keun WOO ; Gi Jeong CHEON ; Byung Il KIM ; Chang Woon CHOI ; Sang Moo LIM
Nuclear Medicine and Molecular Imaging 2009;43(1):72-78
PURPOSE: Bone mineral density (BMD) measurements need to be precise enough to be capable of detecting small changes in bone mass of rats. Using a regular dual-energy X-ray absorptiometry (DXA), we measured many BMD of various skeletal sites in rats to examine precision of DXA in relation to the repositioning on the bones of rats. MATERIALS AND METHODS: Using DXA and small animal software, scans were performed 4 times in all 12 male rats without repositioning (Group 1a). Another four scans for 6 of 12 rats were done with repositioning between scans (Group 2). Customized regions of interest (ROIs), encapsulate the right hind limb, L1-4, skull and pelvic bones were drawn at each measurement. The precision of the measurements was evaluated by measuring the coefficient of variation (CV) of four measurements of BMD at each skeletal site of all rats with or without repositioning. Significance of differences between group 1b (six rats out of group 1a, which were come under group 2) and group2 were evaluated with Wilcoxon Signed Rank Sum Test. RESULTS: CVs obtained at different skeletal sites of all measurements in Group 1b and 2. It was 3.51+/-1.20, 2.62+/-1.20 for the hindlimb (p=0.173), 3.83+/-2.02, 4.59+/-2.02 for L1-4 (p=0.600), 3.73+/-1.87, 1.53+/-0.89 for skull (p=0.046), and 2.92+/-0.60, 1.45+/-0.60 for pelvic bones (p=0.075). CONCLUSION: Our study demonstrates that the DXA technique has the precision necessary when used to assess BMD for various skeletal sites in rats regardless of repositioning.
Absorptiometry, Photon
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Animals
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Bone Density
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Extremities
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Hindlimb
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Humans
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Male
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Pelvic Bones
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Rats
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Skull
5.mage-Based Assessment and Clinical Significance of Absorbed Radiation Dose to Tumor in Repeated High-Dose (131)I Anti-CD20 Monoclonal Antibody (Rituximab) Radioimmunotherapy for Non-Hodgkin's Lymphoma.
Byung Hyun BYUN ; Kyeong Min KIM ; Sang Keun WOO ; Tae Hyun CHOI ; Hye Jin KANG ; Dong Hyun OH ; Byeong Il KIM ; Gi Jeong CHEON ; Chang Woon CHOI ; Sang Moo LIM
Nuclear Medicine and Molecular Imaging 2009;43(1):60-71
PURPOSE: We assessed the absorbed dose to the tumor (Dosetumor) by using pretreatment FDG-PET and whole-body (WB) planar images in repeated radioimmunotherapy (RIT) with 131I rituximab for NHL. MATERIALS AND METHODS: Patients with NHL (n=4) were administered a therapeutic dose of (131)I rituximab. Serial WB planar images after RIT were acquired and overlaid to the coronal maximum intensity projection (MIP) PET image before RIT. On registered MIP PET and WB planar images, 2D-ROIs were drawn on the region of tumor (n=7) and left medial thigh as background, and Dosetumor was calculated. The correlation between Dosetumor and the CT-based tumor volume change after RIT was analyzed. The differences of Dosetumor and the tumor volume change according to the number of RIT were also assessed. RESULTS: The values of absorbed dose were 397.7+/-646.2cGy (53.0~2853.0cGy). The values of CT-based tumor volume were 11.3+/-9.1 cc (2.9~34.2cc), and the % changes of tumor volume before and after RIT were -29.8+/-44.3% (-100.0%~+42.5%), respectively. Dosetumor and the tumor volume change did not show the linear relationship (p>0.05). Dosetumor and the tumor volume change did not correlate with the number of repeated administration (p>0.05). CONCLUSION: We could determine the position and contour of viable tumor by MIP PET image. And, registration of PET and gamma camera images was possible to estimate the quantitative values of absorbed dose to tumor.
Antibodies, Monoclonal, Murine-Derived
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Gamma Cameras
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Humans
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Lymphoma
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Lymphoma, Non-Hodgkin
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Radioimmunotherapy
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Thigh
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Tumor Burden
;
Rituximab
6.Camparison between the 1 Day and the 2 Day Protocols of Lymphoscintigraphy and Sentinel Node Biopsy using Subareolar Injection in Breast Cancer Patients: A Retrospective Study.
Ju Won SEOK ; Sungmin JUN ; Hyun Yeol NAM ; In Ju KIM
Nuclear Medicine and Molecular Imaging 2009;43(1):55-59
PURPOSE: Lymphoscintigraphy and sentinel node biopsy are used in detection of axillary lymph node metastasis in breast cancer patients, but standardized technique is not established. We compared the results of the injection the morning of surgery (1 day protocol) with the subareolar injection the day before surgery (2 day protocol) with the subareolar injection in patients with breast cancer having lymphoscintigraphy and sentinel node biopsy. MATERIALS AND METHODS: This study included 349 patients who underwent the breast cancer operation during 2001-2004. One hundred seventy one patients (1 day protocol, 1 hour) was injected 0.8 ml of Tc-99m Tin-Colloid (37 MBq) by subareolar injection on the morning of surgery. One hundred seventy eight patients (2 day protocol, 16 hour) was injected 0.8 ml of Tc-99m Tin-Colloid (185 MBq) on the afternoon before surgery. Lymphoscintigraphy was performed in sitting position and sentinel node localization was performed by hand-held gamma probe during operation. Result: In the 1 day protocol, 153 cases (89.5%) of the sentinel node were localized by lymphoscintigraphy and 150 cases (87.7%) were localized by gamma probe. In the 2 day protocol, 159 cases (89.3%) were localized by lymphoscintigraphy and 154 cases (86.5%) were localized by gamma probe. There was no significant difference in localization of sentinel node between the 1 day and the 2 day protocol by lymphoscintigraphy and gamma probe (p>0.05, p>0.05). CONCLUSION: There was no difference the result of localization of sentinel node with subareolar injection between the 1 day and the 2 day protocol in breast cancer patients. Because the 2 day protocol allows the enough time of performing lymphoscintigraphy, it is more useful in localization of sentinel node in breast cancer patients.
Biopsy
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Breast
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Breast Neoplasms
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Humans
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Lymph Nodes
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Lymphoscintigraphy
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Neoplasm Metastasis
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Nitriles
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Pyrethrins
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Retrospective Studies
7.The value of Dedicated Tc-99m MIBI Scintimammography in the Evaluation of Patients with Palpable Breast Lesions in Comparison with Mammography: Preliminary Result.
Arthur CHO ; Hojin CHO ; Mijin YUN ; Byeong Woo PARK ; Min Jung KIM ; Eun Kyung KIM ; Won Jun KANG ; Jong Doo LEE
Nuclear Medicine and Molecular Imaging 2009;43(1):48-54
PURPOSE: There are few studies evaluating the usefulness of dedicated high-resolution scintimammography and no studies using delayed washout with this dedicated high resolution scintimammography for the evaluation of breast lesions. We underwent this study to evaluate the clinical usefulness of Tc-99m MIBI in evaluating patients with palpable breast lesions using dedicated high-resolution scintimammography. MATERIALS AND METHODS: This study included 19 patients with 23 palpable breast lesions who underwent mammography. Tc-99m MIBI was taken to further characterize these lesions. Scintimammography images were acquired with standard craniocaudal and mediolateral oblique views and delayed images were additionally taken. Final conclusions were based on histopathology, either by biopsy or mastectomy results. RESULTS: Eighteen lesions were malignant and five were benign. Mammography was indeterminate for thirteen lesions, nine of those were malignant. Mammography also categorized one lesion as benign in a dense breast, but scintimammography and pathology results showed malignancy. Of the five benign lesions, two were visible on scintimammography, but delayed images showed washout. CONCLUSION: Based on our preliminary results, dedicated high resolution scintimammography seems to be very useful in characterizing palpable lesions that were indeterminate or negative on mammography.
Biopsy
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Breast
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Breast Neoplasms
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Humans
;
Mammography
;
Mastectomy
8.Comparison of FDG Uptake with Pathological Parameters in the Well-differentiated Thyroid Cancer.
Woo Hee CHOI ; Yong An CHUNG ; Ki Jun KIM ; Chang Suk PARK ; Hyun Suk JUNG ; Hyung Sun SOHN ; Soo Kyo CHUNG ; Chang Young YOO
Nuclear Medicine and Molecular Imaging 2009;43(1):40-47
PURPOSE: Differentiated thyroid cancer (DTC) has variable degree of F-18 FDG avidity. The purpose of this study was to evaluate the relationship between F-18 FDG uptake and pathological or immunohistochemical features of DTC. MATERIALS AND METHODS: DTC patients who underwent both pre-operative F-18 FDG PET/CT scan and surgery were included in the study. Maximum standardized uptake values (SUVmax) of primary tumor were calculated. If the primary tumor showed no perceptibly increased F-18 FDG uptake, region of interest was drawn based on finding of CT portion of the PET/CT images. Pathological and immunohistochemical markers such as presence of lymph node (LN) metastasis and underlying thyroiditis, tumor size, Ki-67 labeling index, expressions of EGFR, COX-2, and Galectin-3 were evaluated. RESULTS: Total of 106 patients was included (102 papillary carcinomas, 4 follicular carcinomas). The mean SUVmax of the large tumors (above 1 cm) was significantly higher than the mean SUVmax of small (equal to or less than 1 cm) ones (7.8+/-8.5 vs. 3.6+/-3.1, p=0.004). No significant difference in F-18 FDG uptake was found according to the presence or absence of LN metastasis and underlying thyroiditis, or the degree of Ki-67 labeling index, expression of EGFR, COX-2 and Galectin-3. CONCLUSION: In conclusion, the degree of F-18 FDG uptake in DTC was associated with the size of primary tumor. But there seem to be no relationship between F-18 FDG uptake of DTC and expression of Ki-67, EGFR, COX-2 and Galectin-3.
Carcinoma, Papillary
;
Galectin 3
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Humans
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Lymph Nodes
;
Neoplasm Metastasis
;
Thyroid Gland
;
Thyroid Neoplasms
;
Thyroiditis
9.Diffuse Hypermetabolism at Bone Marrow in F-18 FDG PET/CT: Correlation with Bone Marrow Biopsy and Complete Blood Cell Counts.
Yun Hee KANG ; Seok Tae LIM ; Young Jin JEONG ; Dong Wook KIM ; Hwan Jeong JEONG ; Myung Hee SOHN
Nuclear Medicine and Molecular Imaging 2009;43(1):35-39
PURPOSE: Increased FDG uptake in the bone marrow has been reported in patients taking erythropoietin or granulocyte-colony stimulating factor (G-CSF). The aim of this study is to investigate the correlation between F-18 FDG uptake in the bone marrow and bone marrow finding, hematological parameters. MATERIALS AND METHODS: Twenty patients who had diffuse FDG uptake at the bone marrow and received hematological examinations, bone marrow biopsy within 10 days before or after PET/CT were enrolled in this study. Among them, 11 patients were excluded; 4 patients received G-CSF or erythropoietin before PET/CT. Seven patients showed definite pathology in a bone marrow biopsy. The parameters included the measurement of WBC, hemoglobin, platelet and cellularity of the bone marrow. RESULTS: Bone marrow FDG uptake was correlated with a low hemoglobin but not WBC, platelet. Histopathologic findings in marrow biopsies were various: normal finding (n=3), hyperplasia of granulocytic cells (n=2), eosinophilic hyperplasia (n=1), reactive lymphoid nodules (n=1), hypercelluar marrow (n=1), hypocelluar marrow (n=1). All patients except two, showed normal marrow celluarity. CONCLUSION: FDG uptake by bone marrow correlated with anemia but not WBC, platelet, bone marrow cellularity.
Anemia
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Biopsy
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Blood Cell Count
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Blood Cells
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Blood Platelets
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Bone Marrow
;
Bone Marrow Examination
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Eosinophils
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Erythropoietin
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Granulocyte Colony-Stimulating Factor
;
Hemoglobins
;
Humans
;
Hyperplasia
10.Comparison between FDG Uptake and Clinicopathologic and Immunohistochemical Parameters in Pre-operative PET/CT Scan of Primary Gastric Carcinoma.
Eun Ji HAN ; Woo Hee CHOI ; Yong An CHUNG ; Ki Jun KIM ; Lee So MAENG ; Kyung Myung SOHN ; Hyun Suk JUNG ; Hyung Sun SOHN ; Soo Kyo CHUNG
Nuclear Medicine and Molecular Imaging 2009;43(1):26-34
PURPOSE: The purpose of this study was to find out what clinicopathologic or immunohistochemical parameter that may affect FDG uptake of primary tumor in PET/CT scan of the gastric carcinoma patient. MATERIALS AND METHODS: Eighty-nine patients with stomach cancer who underwent pre-operative FDG PET/CT scans were included. In cases with perceptible FDG uptake in primary tumor, the maximum standardized uptake value (SUVmax) was calculated. The clinicopathologic results such as depth of invasion (T stage), tumor size, lymph node metastasis, tumor differentiation and Lauren's classification and immunohistochemical markers such as Ki-67 index, expression of p53, EGFR, Cathepsin D, c-erb-B2 and COX-2 were reviewed. RESULTS: Nineteen out of 89 gastric carcinomas showed imperceptible FDG uptake on PET/CT images. In cases with perceptible FDG uptake in primary tumor, SUVmax was significantly higher in T2, T3 and T4 tumors than T1 tumors (5.8+/-3.1 vs. 3.7+/-2.1, p=0.002). SUVmax of large tumors (above or equal to 3 cm) was also significantly higher than SUVmax of small ones (less than 3 cm) (5.7+/-3.2 vs. 3.7+/-2.0, p=0.002). The intestinal types of gastric carcinomas according to Lauren showed higher FDG uptake compared to the non-intestinal types (5.4+/-2.8 vs. 3.7+/-1.3, p=0.003). SUVmax between p53 positive group and negative group was significantly different (6.0+/-2.8 vs. 4.4+/-3.0, p=0.035). No significant difference was found in presence of LN metastasis, tumor differentiation, Ki-67 index, and expression of EGFR, Cathepsin D, c-erb-B2 and COX-2. CONCLUSION: T stage of gastric carcinoma influenced the detectability of gastric cancer on FDG PET/CT scan. When gastric carcinoma was perceptible on PET/CT scan, T stage, size of primary tumor, Lauren's classification and p53 expression were related to degree of FDG uptake in primary tumor.
Cathepsin D
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Humans
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Lymph Nodes
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Neoplasm Metastasis
;
Stomach Neoplasms