PURPOSE: The measurement of radiation absorbed dose is useful to predict the response after I-131 labeled metaiodobenzylguanidine (MIBG) therapy and determine therapy dose in patients with unresectable or malignant pheochromocytoma. We estimated the absorbed dose in tumor tissue after high dose I-131 MIBG in a patient with pheochromocytoma using a gamma camera and Medical Internal Radiation Dose (MIRD) formula. MATERIALS AND METHODS: A 64-year old female patient with pheochromocytoma who had multiple metastases of mediastinum, right kidney and periaortic lymph nodes, received 74 GBq (200 mCi) of I-131 MIBG. We obtained anterior and posterior images at 0.5, 16, 24, 64 and 145 hours after treatment. Two standard sources of 37 and 74 MBq of I-131 were imaged simultaneously. Cummulated I-131 MIBG uptake in tumor tissue was calculated after the correction of background activity, attenuation, system sensitivity and count loss at a high count rate. RESULTS: The calculated absorbed radiation dose was 32-63 Gy/ 74 GBq, which was lower than the known dose for tumor remission (150-200 Gy). Follow-up studies at 1 month showed minimally reduced tumor size on computed tomography, and mildly reduced I-131 MIBG uptake. CONCLUSION: We estimated radiation absorbed dose after therapeutic I-131 MIBG using a gamma camera and MIRD formula, which can be peformed in a clinical nuclear medicine laboratory. Our RESULTS suggest that the measurement of radiation absorbed dose in I-131 MIBG therapy is feasible as a routine clinical practice that can guide further treatment plan. The accuracy of dose measurement and correlation with clinical outcome should be evaluated further.
3-Iodobenzylguanidine ; Female ; Follow-Up Studies ; Gamma Cameras ; Humans ; Kidney ; Lymph Nodes ; Mediastinum ; Middle Aged ; Neoplasm Metastasis ; Nuclear Medicine ; Pheochromocytoma

PURPOSE: The purpose of this study was to evaluate the diagnostic accuracy of [18F]FDG PET in the diagnosis of recurrent head and neck cancer after the completion of surgery and radiotherapy in patients with head and neck cancers. MATERIALS AND METHODS: In fifty-nine patients with head and neck cancers, whole body [18F]FDG PET studies were performed. According to the different therapeutic modalities, patients were divided into four groups (Group I; pre-treatment, Group II; surgery, Group III; radiotherapy, Group IV; both surgery and radiotherapy). [18F]FDG PET images were compared with clinical, CT and histopathologic findings. RESULTS: For detection of metastatic lymph nodes in 14 patients of pre-treatment group (group I), the sensitivity and specificity of PET were 100% (10/10) and 75% (3/4), and those of CT were 80% (8/10) and 100% (4/4). For detection of recurrence in 45 patients of post-treatment group, overall sensitivity and specificity of PET were 96.2% (25/26) and 78.9% (15/19) [(100% and 75% in group II, 80% and 50% in group III, and 100% and 100% in group IV)] without significant difference from pre-treatment group (p>0.1). In detecting recurrence, the sensitivity and specificity of [18F]FDG PET were 90.9% (10/11) and 20% (1/5) in 16 patients who underwent [18F]FDG PET within 2 months after the completion of treatment. The specificity of these patients was significantly lower than that of 29 patients (100% of sensitivity and specificity) who underwent [18F]FDG PET 2 months after treatment (p<0.05). CONCLUSION: [18F]FDG PET is an accurate diagnostic modality for the detection of recurrence in head and neck cancer. Post-therapy [18F]FDG PET should be obtained at least 2 months after the completion of surgery or radiotherapy.
Diagnosis ; Head and Neck Neoplasms ; Head* ; Humans ; Lymph Nodes ; Neck* ; Radiotherapy* ; Recurrence ; Sensitivity and Specificity

No abstract available.
Humans ; Stomach Neoplasms* ; Stomach*

PURPOSE: It is important to differentiate malignant from benign lesions of intraocular masses in choosing therapeutic plan. Biopsy of intraocular tumor is not recommended due to the risk of visual damage. We evaluated the usefulness of F-18-FDG PET imaging in diagnosing intraocular neoplasms. MATERIALS AND METHODS: F-l8-FDG PET scan was performed in 13 patients (15 lesions) suspected to have malignant intraocular tumors. There were 3 benign lesions (retinal detachment, choroidal effusion and hemorrhage) and 10 patients with 12 malignant lesions (3 melanomas, 7 retinoblastomas and 2 metastatic cancers). Regional eye images (256*256 and 128*128 matrices) were obtained with or without attenuation correction. Whole body scan was also performed in eight patients (3 benign and 6 malignant lesions). RESULTS: All malignant lesions were visualized while all benign lesions were not visualized. The mean peak standardized uptake value (SUV) of malignant lesions was 2.64+/-0.57 g/ml. There was no correlations between peak SUV and tumor volume. Two large malignant lesions (>1000 mm3 ) showed hot uptake on whole body scan. But two medium-sized lesions (100-l000 mm3) looked faint and two small (<100 mm3) lesions were not visualized. The images reconstructed with 256*256 matrix showed lesions more clearly than those with 128X128 matrix. CONCLUSION: F-18-FDG PET scan is highly sensitivity in detecting malignant intraocular tumor. For the evaluation of small-sized intraocular lesions, whole body scan is not appropriate because of low sensitivity. A regional scan with sufficient acquisition time is recommended for that purpose. Image reconstruction in matrix size of 256*256 produced clearer images than the ones in 128X128, but it does not affect the diagnostic sensitivity.
Biopsy ; Choroid ; Diagnosis* ; Humans ; Image Processing, Computer-Assisted ; Melanoma ; Orbital Neoplasms ; Positron-Emission Tomography ; Retinoblastoma ; Tumor Burden ; Whole Body Imaging

No abstract available.
Kidney* ; Perfusion* ; Radionuclide Imaging*

The goal of surgical stone management is to achieve maximal stone clearance with minimal morbidity to the patient. Because of its efficacy, efficiency and low morbidity, extracorporeal shock wave lithotripsy(ESWL) is the first-line treatment for almost all urinary calculi. However, stone clearance after ESWL has been shown to be affected by the stone burden, location, chemical composition and kidney anatomy. Especially, the success rate for ESWL is reduced in lower pole stone(LPS). Percutaneous nephrolithotomy(PNL) and retrograde ureteroscopic intrarenal surgery(RIRS) are alternative treatment options for stones refractory to ESWL such as LPS. Although effective, PNLsubjects the patient to increased morbidity compared to ESWL and RIRS. Because of its low morbidity and relatively high success rate, RIRS for LPS is an attractive treatment modality in selective patients. We report a case of multiple renal pelvis and lower calyceal stones treated with ureteroscopy.
Humans ; Kidney ; Kidney Calculi ; Kidney Pelvis* ; Shock ; Ureteroscopy ; Urinary Calculi

No abstract available.
Captopril* ; Diagnosis* ; Hypertension, Renovascular* ; Radionuclide Imaging*

No abstract available.
Brain* ; Tomography, Emission-Computed, Single-Photon*

Preadipocyte factor-1 (Pref-1) is expressed in the neuroendocrine organs such as the pituitary gland, the adrenal gland, the pancreas, the testis, etc. Vitamin D3 up-regulated protein 1(VDUP1) gene is known to be a novel member of early response genes as an oxidative stress mediator. The aim of the present study was to investigate whether Pref-1 and VDUP1 is involved in stress response in the adrenal gland following chronic immobilization stress. In situ hybridization for Pref-1 and VDUP1 genes (Pref-1 and VDUP1) was performed in the rat adrenal glands following immobilization stress, 2 hr once daily for 7 days. In situ hybridization analysis revealed that Pref-1 expression was up-regulated in rat adrenal medulla following chronic immobilization stress. However, Pref-1 was down-regulated in the zona glomerulosa of the adrenal cortex following chronic immobilization stress. VDUP1 expression was up-regulated in the zona glomerulosa and the adrenal medulla following chronic immobilization stress. These results show that Pref-1 and VDUP1 may be novel genes responding to chronic immobilization stress in adrenal gland.
Adrenal Cortex ; Adrenal Glands* ; Adrenal Medulla ; Animals ; Cholecalciferol* ; Immobilization* ; In Situ Hybridization ; Oxidative Stress ; Pancreas ; Pituitary Gland ; Rats* ; Testis ; Vitamins* ; Zona Glomerulosa

Cysts of the adrenal glands are uncommon and present difficult problems in differential diagnosis. In autopsy studies, the incidence of adrenal cysts is ranges from 0.064% to 0.18%. Recently, we have experienced a 22-year-old female patient with spontaneous hemorrhagic pseudocyst of adrenal gland without known cause, presenting symptoms of nausea, epigastric discomfort and intermittent pain of right upper abdomen. In clinical presentation, abdominal ultrasonogram and computerized tomogram suggest cystic degeneration of malignant pheochromocytoma, but screening hormonal evaluation was normal. Selective adrenal venous sampling, adrenal scintigram and pathologic examination were not compatible with the functioning adrenal cortical or medullary adenoma/carcinoma, the mass results in spantaneous hemorrhagic necrosis and cystic degeneratio#n of adrenal gland. The authors reported a case of spontaneous hemorrhagic pseudocyst of adrenal gland, which was successfully resected by laparoscopic excision with reviews of the literatures.
Abdomen ; Adrenal Glands* ; Autopsy ; Diagnosis, Differential ; Female ; Humans ; Incidence ; Mass Screening ; Nausea ; Necrosis ; Pheochromocytoma* ; Ultrasonography ; Young Adult