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Incidental Visualization of Thyroid Gland on Bone Scan Caused by Graves' Hyperthyroidism.

Myung Hee SOHN ; Hwan Jeong JEONG ; Dong Wook KIM ; Seok Tae LIM

Nuclear Medicine and Molecular Imaging.2009;43(2):154-155.

A 45-year-old man presented with fatigue and weight loss underwent a Tc-99m MDP bone scan because of increased serum alkaline phosphatase. Delayed images at 4 hours demonstrated diffuse increased activity throughout both lobes of the thyroid in the absence of activity of the stomach and salivary glands. Thyroid laboratory indices and a Tc-99m pertechnetate thyroid scan suggested Graves' hyperthyroidism.
Alkaline Phosphatase ; Fatigue ; Graves Disease ; Humans ; Hyperthyroidism ; Middle Aged ; Salivary Glands ; Sodium Pertechnetate Tc 99m ; Stomach ; Technetium Tc 99m Medronate ; Thyroid Gland ; Weight Loss

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18F-FDG PET/CT Finding in a Case of Xanthogranulomatous Pyelonephritis.

Bong Hoi CHOI ; Sun Pyo HONG ; Joon Kee YOON ; Ki Soo PAI ; Jeong HONG ; Hyun Ee YIM

Nuclear Medicine and Molecular Imaging.2009;43(2):150-153.

Xanthogranulomatous pyelonephritis is an uncommon chronic renal infection, which is usually found on middle-aged women and is rare in infant. Sometimes it forms focal mass like lesion of kidney with pathologically characteristic lipid-laden macrophage. A 1-month female infant was admitted for fever and moaning sound. On work-up of urinary tract infection, abdomen ultrasonography and computed tomography revealed a large mass on the upper portion of right kidney and PET/CT showed homogeneously increased 18F-FDG uptake. The radical nephrectomy of right kidney was performed and histology revealed a focal xanthogranulomatous pyelonephritis. To our knowledge, this is the first report presenting the finding of 18F-FDG PET/CT in the childhood xanthogranulomatous pyelonephritis.
Abdomen ; Female ; Fever ; Fluorodeoxyglucose F18 ; Humans ; Infant ; Kidney ; Macrophages ; Nephrectomy ; Pyelonephritis, Xanthogranulomatous ; Urinary Tract Infections

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Prediction of Splint Therapy Efficacy Using Bone Scan in Patients with Unilateral Temporomandibular Disorder.

Sang Mi LEE ; Won Woo LEE ; Pil Young YUN ; Young Kyun KIM ; Sang Eun KIM

Nuclear Medicine and Molecular Imaging.2009;43(2):143-149.

PURPOSE: It is not known whether bone scan is useful for the prediction of the prognosis of patients with temporomandibular disorders (TMD). The aim of the present study was to identify useful prognostic markers on bone scan for the pre-therapeutic assessment of patients with unilateral TMD. MATERIALS AND METHODS: Between January 2005 and July 2007, 55 patients (M:F=9:46; mean age, 34.7+/-14.1 y) with unilateral TMD that underwent a pre-therapeutic bone scan were enrolled. Uptake of Tc-99m HDP in each temporomandibular joint (TMJ) was quantitated using a 13X13 pixel-square region-of-interest over TMJ and parietal skull area as background. TMJ uptake ratios and asymmetric indices were calculated. TMD patients were classified as improved or not improved and the bone scan findings associated with each group were investigated. RESULTS: Forty-six patients were improved, whereas 9 patients were not improved. There was no significant difference between the two groups of patients regarding the TMJ uptake ratio of the involved joint, the TMJ uptake ratio of the non-involved joint, and the asymmetric index (p>0.05). However, in a subgroup analysis, the patients with an increased uptake of Tc-99m HDP at the disease-involved TMJ, by visual assessment, could be easily identified by the asymmetric index; the patients that improved had a higher asymmetric index than the patients that did not improve (1.32+/-0.35 vs. 1.08+/-0.04, p=0.023). CONCLUSION: The Tc-99m HDP bone scan may help predict the prognosis of patients with unilateral TMD after splint therapy when the TMD-involved joint reveals increased uptake by visual assessment.
Humans ; Joints ; Prognosis ; Skull ; Splints ; Temporomandibular Joint ; Temporomandibular Joint Disorders

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Current Status and Problems of PET/CT Data on CD for Inter-hospital Transfer.

Seung Hyup HYUN ; Joon Young CHOI ; Su Jin LEE ; Young Seok CHO ; Ji Young LEE ; Miju CHEON ; Suk Kyong CHO ; Kyung Han LEE ; Byung Tae KIM

Nuclear Medicine and Molecular Imaging.2009;43(2):137-142.

PURPOSE: This study was performed to find the current problems of positron emission tomography / computed tomography (PET/CT) data on CD for inter-hospital transfer. MATERIALS AND METHODS: The subjects were 746 consecutive 18F-fluorodeoxyglucose PET/CT data CDs from 56 hospitals referred to our department for image interpretation. The formats and contents of PET/CT data CDs were reviewed and the email questionnaire survey about this was performed. RESULTS: PET/CT data CDs from 21 of 56 hospitals (37.5%) included all transaxial CT and PET images with DICOM standard format which were required for authentic interpretation. PET/CT data from the others included only secondary capture images or fusion PET/CT images. According to this survey, the main reason of limited PET/CT data on CD for inter-hospital transfer was that the data volume of PET/CT was too large to upload to the Picture Archiving and Communication System. CONCLUSION: The majority of hospitals provided limited PET/CT data on CD for inter-hospital transfer, which could be inadequate for accurate interpretation and clinical decision making. It is necessary to standardize the format of PET/CT data on CD for inter-hospital transfer including all transaxial CT and PET images with DICOM standard format.
Decision Making ; Electronic Mail ; Positron-Emission Tomography ; Positron-Emission Tomography and Computed Tomography ; Surveys and Questionnaires

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Optimal Imaging Time for Diagnostic I-123 Whole Body Scan in the Follow-up of Patients with Differentiated Thyroid Cancer: Comparison between 6- and 24-Hour Images of the Same Subjects.

Hong Je LEE ; Sang Woo LEE ; Bong Il SONG ; Sung Min KANG ; Ji Hyoung SEO ; Jeongsoo YOO ; Byeong Cheol AHN ; Jaetae LEE

Nuclear Medicine and Molecular Imaging.2009;43(2):129-136.

PURPOSE: To determine optimal imaging time for diagnostic I-123 whole body scan in the follow-up of patients with differentiated thyroid cancer (DTC), we compared the image quality of 6- and 24-hour images of the same subjects. MATERIALS AND METHODS: Four hundred ninety-eight patients (M:F=55:443, Age 47.6+/-12.9 years) with DTC who had undergone total thyroidectomy and I-131 ablation therapy underwent diagnostic whole body scanning 6 hour and 24 hour after oral ingestion of 185 MBq (5 mCi) of I-123. Serum thyroglobulin measurement and ultrasonography of the neck were performed at the time of imaging. In 40 patients underwent additional I-131 therapy, post-therapy I-131 images were obtained and compared with diagnostic I-123 images. RESULTS: In 440 patients (88.4%), 6- and 24-hour diagnostic I-123 images were concordant, and 58 patients (11.6%) showed discordant findings. Among 58 discordant patients, 31 patients showed abnormal tracer uptake on only 6-hour image, which turned out false-positive findings in all cases. In 12 patients with positive findings on only 24-hour image, remnant thyroid tissue (4 patients) and cervical lymph node metastasis (3 patients) were presented. Among 40 patients underwent additional I-131 therapy, 6-hour and 24-hour images were discordant in 13 patients. All 5 patients with abnormal uptake on only 6-hour image revealed false-positive results, whereas most of 24-hour images were concordant with post-therapy I-131 images. CONCLUSION: I-123 imaging at 24-hour could reduce false-positive findings and improve diagnostic accuracy, compared with 6-hour image in the follow-up of patient with DTC.
Eating ; Follow-Up Studies ; Humans ; Lymph Nodes ; Neck ; Neoplasm Metastasis ; Thyroglobulin ; Thyroid Gland ; Thyroid Neoplasms ; Thyroidectomy ; Whole Body Imaging

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Diagnostic Role of F-18 FDG PET/CT in the Follow-up of Patients with Colorectal Cancer: Comparison with Serum CEA, CA 19-9 Levels and Computed Tomography.

Sungmin KANG ; Bong Il SONG ; Hong Je LEE ; Ji Hyoung SEO ; Sang Woo LEE ; Jeongsoo YOO ; Byeong Cheol AHN ; Jaetae LEE ; Kyusuk CHOI ; Soo Han JUN

Nuclear Medicine and Molecular Imaging.2009;43(2):120-128.

PURPOSE: Early detection of recurrence is an important factor for long term survival of patients with colorectal cancer. Measurement of serum levels of CEA, CA 19-9, CT and PET/CT has been commonly used in the postoperative surveillance of colorectal cancer. The purpose of this study was to compare the diagnostic ability of PET/CT, tumor marker and CT for recurrence in colorectal cancer patients after treatment. MATERIALS AND METHODS: F-18 FDG PET/CT imaging was performed in 189 colorectal cancer patients who underwent curative surgical resection and/or chemotherapy. Measurement of serum levels of CEA, CA 19-9 and CT imaging were performed within 2 months of PET/CT examination. Final diagnosis of recurrence was made by biopsy, radiologic studies or clinical follow-up for 6 months after each study. RESULTS: Overall sensitivity, specificity of PET/CT was 94.7%, 91.1%, while those of serum CEA were 44.7% and 97.3%, respectively. Sensitivity and specificity were 94.2%, 90.4% for PET/CT and better than those of combined CEA and CA 19-9 measurement (52.1%, 88.5%) in 174 patients measured available both CEA and CA 19-9 data. In 115 patients with both tumor markers and CT images available, PET/CT showed similar sensitivity but higher specificity (92.9%, 91.3%) compared to combination of tumor markers and CT images (92.9%, 74.1%). CONCLUSION: PET/CT was superior for detection of recurred colorectal cancer patients compared with both CEA, CA 19-9, and even with combination of both tumor markers and CT. Therefore PET/CT could be used as a routine surveillance examination to detect recurrence or metastasis of colorectal cancer.
Biopsy ; Carcinoembryonic Antigen ; Colorectal Neoplasms ; Follow-Up Studies ; Humans ; Neoplasm Metastasis ; Recurrence ; Sensitivity and Specificity ; Biomarkers, Tumor

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Clinical Significance of Reverse Redistribution Phenomenon on Delayed Tc-99m Tetrofosmin Myocardial Perfusion Imaging in Patients with Acute Myocardial Infarction.

Soon Ah PARK ; Dae Weung KIM ; Chang Guhn KIM ; Jin Won JEONG ; Nam Ho KIM ; Kyeong Ho YUN

Nuclear Medicine and Molecular Imaging.2009;43(2):112-119.

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

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Alterations of Regional Cerebral Blood Flow in Major Depressive Disorder.

Won Hyoung LEE ; Yong An CHUNG ; Ye Young SEO ; Ik Dong YOO ; Sae Jung NA ; Hyun Suk JUNG ; Ki Jun KIM

Nuclear Medicine and Molecular Imaging.2009;43(2):107-111.

PURPOSE: The authors analyzed how the regional cerebral blood flow (rCBF) findings of patients with major depression differ from the normal control, and our results were compared to previous reports. MATERIALS AND METHODS: Twelve patients fulfilling DSM-IV criteria for major depression who were off all psychotropic medications for >4weeks (male: 7, female: 5, age range: 19~52 years, average age: 29.3+/-9.9 years) and 14 normal volunteers (male: 8, female: 6, age range: 19~53 years, average age: 31.4+/-9.2 years) were recruited. Images of brain perfusion SPECT were obtained using Tc-99m ECD and patterns of the rCBF were compared between patients with major depression and the healthy control subjects. RESULTS: The patients with major depression showed increase of the r-CBF in right lingual gyrus, right fusiform gyrus, left lingual gyrus, left precuneus, and left superior temporal gyrus, and showed decrease of r-CBF in right pons, left medial frontal gyrus, cingulate gyrus of left limbic lobe, cingulate gyrus of right frontal lobe, and cingulate gyrus of right limbic lobe compared to the normal control. CONCLUSION: The Tc-99m ECD brain perfusion SPECT findings in our study did not differ from the previously reported regional cerebral blood flow pattern of patients with major depression. Especially, decreased rCBF pattern typical to major depression patients in the right pons, left medial frontal gyrus, and cingulate regions was clearly demonstrated.
Brain ; Cysteine ; Depression ; Depressive Disorder, Major ; Diagnostic and Statistical Manual of Mental Disorders ; Frontal Lobe ; Gyrus Cinguli ; Humans ; Organotechnetium Compounds ; Perfusion ; Pons ; Tomography, Emission-Computed, Single-Photon

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Differentiation of Parkinson's Disease and Essential Tremor on I-123 IPT(I-123-N-(3-iodopropen-2-yl)-2beta-carbomethoxy-3beta(4-cholorophenyl) tropane) Brain SPECT.

Moonsun PAI ; Tae Hyun CHOI ; Sung Min AHN ; Jai Yong CHOI ; Won Gee RYU ; Jae Hoon LEE ; Young Hoon RYU

Nuclear Medicine and Molecular Imaging.2009;43(2):100-106.

PURPOSE: The study was to assess I-123-N-(3-iodopropen-2-yl)-2[beta]-carbomethoxy-3[beta]-(4-cholorophenyl) tropane (IPT) SPECT in differential diagnosis among early stage of Parkinson's disease(PD) and essential tremor(ET) and normal control(NL) groups quantitatively. MATERIALS AND METHODS: I-123 IPT brain SPECT of 50 NL, 20 early PD, 30 advanced PD, and 20 ET were performed at 20 minutes and 2 hours. Specific/nonspecific binding of striatum was calculated by using right and left striatal specific to occipital non-specific uptake ratio (striatum-OCC/OCC). RESULTS: Mean value of specific/nonspecific binding ratio was significantly different between advanced PD group and NL group. However, significant overlap of striatal specific/nonspecific binding ratio was observed between PD group and ET group. Bilateral striatal specific/nonspecific binding ratios were decreased in advanced PD. Lateralized differences in the striatal uptake of I-123 IPT correlated with asymmetry in clinical findings in PD group. CONCLUSION: I-123 IPT SPECT may be a useful method for the diagnosis of PD and objective evaluation of progress of clinical stages. Care should be made in the differential diagnosis of early stage of PD and other motor disturbances mimicking PD such as ET in view of significant overlap in striatal I-123 specific/nonspecific binding ratio.
Brain ; Diagnosis, Differential ; Dopamine Plasma Membrane Transport Proteins ; Essential Tremor ; Parkinson Disease ; Tomography, Emission-Computed, Single-Photon

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Nucleophilic Fluorination Reactions in Novel Reaction Media for 18F-Fluorine Labeling Method.

Dong Wook KIM ; Hwan Jeong JEONG ; Seok Tae LIM ; Myung Hee SOHN

Nuclear Medicine and Molecular Imaging.2009;43(2):91-99.

Noninvasive imaging of molecular and biological processes in living subjects with positron emission tomography (PET) provides exciting opportunities to monitor metabolism and detect diseases in humans. Measuring these processes with PET requires the preparation of specific molecular imaging probes labeled with 18F-fluorine. In this review we describe recent methods and novel trends for the introduction of 18F-fluorine into molecules which in turn are intended to serve as imaging agents for PET study. Nucleophilic 18F-fluorination of some halo- and mesyloxyalkanes to the corresponding 18F-fluoroalkanes with 18F-fluoride obtained from an 18O(p,n)18F reaction, using novel reaction media system such as an ionic liquidor tert-alcohol, has been studied as a new method for 18F-fluorine labeling. Ionic liquid method is rapid and particularly convenient because 18F-fluoride in H2O can be added directly to the reaction media, obviating the careful drying that is typically required for currently used radiofluorination methods. The nonpolar protic tert-alcohol enhances the nucleophilicity of the fluoride ion dramatically in the absence of any kind of catalyst, greatly increasing the rate of the nucleophilic fluorination and reducing formation of byproducts compared with conventional methods using dipolar aprotic solvents. The great efficacy of this method is a particular advantage in labeling radiopharmaceuticals with 18F-fluorine for PETimaging, and it is illustrated by the synthesis of 18F-fluoride radiolabeled molecular imaging probes, such as 18F-FDG, 18F-FLT, 18F-FP-CIT, and 18F-FMISO, in high yield and purity and in shorter times compared to conventional syntheses
Biological Processes ; Dideoxynucleosides ; Fluorides ; Fluorodeoxyglucose F18 ; Halogenation ; Humans ; Imidazoles ; Misonidazole ; Molecular Imaging ; Nitro Compounds ; Organothiophosphorus Compounds ; Positron-Emission Tomography ; Radiopharmaceuticals ; Solvents

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