1.Prognostic Significance of Pretreatment 18F-FDG PET/CT Parameters in Patients With ER+/HER2- Metastatic Breast Cancer Treated With CDK4/6 Inhibitors Plus Endocrine Therapy
Minseung SUH ; Jeongryul RYU ; Hojin SONG ; Jae Ho JEONG ; Sangwon HAN ; Hyehyun JEONG ; Jeong Eun KIM ; Yeokyeong SHIN ; Byung-Kwan JEONG ; Hee Jin LEE ; Gyungyub GONG ; Jin-Hee AHN ; Kyung Hae JUNG ; Sung-Bae KIM ; Dae Hyuk MOON
Korean Journal of Radiology 2026;27(4):363-374
Objective:
Cyclin-dependent kinase 4/6 (CDK4/6) inhibitors combined with endocrine therapy (ET) constitute the standard systemic treatment for estrogen receptor-positive, human epidermal growth factor 2-negative (ER+/HER2-) metastatic breast cancer (MBC). However, treatment responses remain heterogeneous, highlighting the need for reliable prognostic markers. This study aimed to evaluate the prognostic significance of 18F-fluorodeoxyglucose (FDG) PET/CT findings in this setting.
Materials and Methods:
This retrospective single-center cohort study included patients with ER+/HER2- MBC who underwent18F-FDG PET/CT before initiating CDK4/6 inhibitors plus ET between 2018 and 2023. Maximum standardized uptake value(SUVmax), whole-body metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured. Progression-free survival (PFS) and overall survival (OS) were evaluated as the primary and secondary outcomes, respectively, using multivariable Cox models. PET parameters (SUVmax, MTV, and TLG) were analyzed as both continuous and dichotomized variables based on median values, adjusting for relevant clinical covariates.
Results:
Among the 374 patients, 82 (21.9%) presented with de novo metastatic disease, and 357 (95.5%) received CDK4/6 inhibitors as first-line therapy. In multivariable Cox analysis, all continuous PET parameters were independently associated with PFS (adjusted hazard ratio for SUVmax 1.05 [95% confidence interval 1.02–1.08]; log-transformed MTV 1.16 [1.08–1.25]; and log-transformed TLG 1.14 [1.07–1.23]) and OS (SUVmax 1.08 [1.04–1.11]; log-transformed MTV 1.24 [1.12–1.38]; and log-transformed TLG 1.22 [1.11–1.34]) with all P < 0.001. Results based on dichotomized PET parameters were similar to those obtained with continuous values: PFS (adjusted hazard ratio for SUVmax ≥ 7.6, 1.41 [1.08–1.85]; MTV ≥ 21.2 cm 3 , 1.41 [1.08–1.86]; and TLG ≥ 78.9, 1.51 [1.14–1.99]) with P ≤ 0.013 and OS (1.43 [1.01–2.04]; 1.84 [1.28– 2.66]; and 1.73 [1.20–2.50], respectively) with P ≤ 0.046.
Conclusion
Pretreatment 18F-FDG PET/CT parameters are independent prognostic markers in patients with ER+/HER2- MBC receiving CDK4/6 inhibitors with ET, supporting their potential utility in risk stratification.
2.The Role of Lung Ventilation/Perfusion Scan in the Management of Chronic Thromboembolic Pulmonary Hypertension
Nuclear Medicine and Molecular Imaging 2024;58(7):449-458
Chronic thromboembolic pulmonary hypertension (CTEPH), which is classified as a group 4 pulmonary hypertension (PH), is a life-threatening complication of acute pulmonary embolism (PE). With the introduction of multidisciplinary approaches and innovative treatment strategies for CTEPH, it is currently regarded not as a fatal disease, but as a curable form of PH.Ventilation/perfusion (V/Q) scan is the preferred imaging method for screening for CTEPH, with superior sensitivity to CT pulmonary angiography. The findings and interpretations of V/Q scan in CTEPH may differ from those observed in acute PE. The use of V/Q scan in combination with SPECT or SPECT/CT is becoming more popular than planar scan alone.Comprehensive understanding of the role of V/Q scan in CTEPH will assist in providing early diagnosis, proper therapeutic decision making, and improved prognosis. This review outlines the current roles and potential clinical applications of V/Q scan in the diagnosis and evaluation of CTEPH.
3.The Role of Lung Ventilation/Perfusion Scan in the Management of Chronic Thromboembolic Pulmonary Hypertension
Nuclear Medicine and Molecular Imaging 2024;58(7):449-458
Chronic thromboembolic pulmonary hypertension (CTEPH), which is classified as a group 4 pulmonary hypertension (PH), is a life-threatening complication of acute pulmonary embolism (PE). With the introduction of multidisciplinary approaches and innovative treatment strategies for CTEPH, it is currently regarded not as a fatal disease, but as a curable form of PH.Ventilation/perfusion (V/Q) scan is the preferred imaging method for screening for CTEPH, with superior sensitivity to CT pulmonary angiography. The findings and interpretations of V/Q scan in CTEPH may differ from those observed in acute PE. The use of V/Q scan in combination with SPECT or SPECT/CT is becoming more popular than planar scan alone.Comprehensive understanding of the role of V/Q scan in CTEPH will assist in providing early diagnosis, proper therapeutic decision making, and improved prognosis. This review outlines the current roles and potential clinical applications of V/Q scan in the diagnosis and evaluation of CTEPH.
5.A Rare Case of Hamartoma in Nasolacrimal Duct
Gyeong Min LEE ; Sangwon JUNG ; Yeon Bi HAN ; Namju KIM
Korean Journal of Ophthalmology 2024;38(3):266-268
6.Comparison of SUVA/V and SUVA‑V for Evaluating AtheroscleroticInflammation in 18F‑FDG PET/CT
Jeongryul RYU ; Shin Ae HAN ; Sangwon HAN ; Sunju CHOI ; Dae Hyuk MOON ; Minyoung OH
Nuclear Medicine and Molecular Imaging 2024;58(1):25-31
Purpose:
This study aimed to compare the clinical significance of two parameters, division of standardized uptake value (SUV) of target arterial activity by background venous blood pool activity ( SUVA/V ) and subtraction of background venous blood pool activity from SUV of target arterial activity (SUVA‑V ) of carotid arteries with atherosclerotic plaques using 18F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET/CT).
Methods:
Patients aged 50 years or more who were diagnosed with carotid artery stenosis of 50% or more with carotid Doppler ultrasonography and had torso 18F-FDG PET/CT were enrolled retrospectively and classified patients who developed cerebrovascular events (CVEs) within 5 years after 18F-FDG PET/CT scan as the active group and patients who did not experience the CVE within 5 years as an inactive group. We calculated SUVA/V and SUVA‑V using measurements of SUVmax
Results:
SUVA‑V SUVA‑V_high , and SUVA‑V_low were significantly higher in the active group than in the inactive group, but neithe SUVA/V SUVA‑V_high , nor SUVA‑V_low showed significant differences between the active and inactive groups. Thedifference in rank between groups of SUVA‑V_high and SUVA‑V_low was greater than the difference in rank between groups of SUVA‑V_high and SUVA‑V_low . The CVE incidence differed between SUVA‑V_high and SUVA‑V_low of high carotid FDG uptake, but the CVE incidence did not differ between SUVA‑V_high and SUVA‑V_low of high carotid FDG uptake.
Conclusion
SUVA‑V may be a more rational solution than SUVA/V for evaluating atherosclerotic plaque inflammation on 18F-FDG PET/CT.
7.The Role of Lung Ventilation/Perfusion Scan in the Management of Chronic Thromboembolic Pulmonary Hypertension
Nuclear Medicine and Molecular Imaging 2024;58(7):449-458
Chronic thromboembolic pulmonary hypertension (CTEPH), which is classified as a group 4 pulmonary hypertension (PH), is a life-threatening complication of acute pulmonary embolism (PE). With the introduction of multidisciplinary approaches and innovative treatment strategies for CTEPH, it is currently regarded not as a fatal disease, but as a curable form of PH.Ventilation/perfusion (V/Q) scan is the preferred imaging method for screening for CTEPH, with superior sensitivity to CT pulmonary angiography. The findings and interpretations of V/Q scan in CTEPH may differ from those observed in acute PE. The use of V/Q scan in combination with SPECT or SPECT/CT is becoming more popular than planar scan alone.Comprehensive understanding of the role of V/Q scan in CTEPH will assist in providing early diagnosis, proper therapeutic decision making, and improved prognosis. This review outlines the current roles and potential clinical applications of V/Q scan in the diagnosis and evaluation of CTEPH.
8.The Role of Lung Ventilation/Perfusion Scan in the Management of Chronic Thromboembolic Pulmonary Hypertension
Nuclear Medicine and Molecular Imaging 2024;58(7):449-458
Chronic thromboembolic pulmonary hypertension (CTEPH), which is classified as a group 4 pulmonary hypertension (PH), is a life-threatening complication of acute pulmonary embolism (PE). With the introduction of multidisciplinary approaches and innovative treatment strategies for CTEPH, it is currently regarded not as a fatal disease, but as a curable form of PH.Ventilation/perfusion (V/Q) scan is the preferred imaging method for screening for CTEPH, with superior sensitivity to CT pulmonary angiography. The findings and interpretations of V/Q scan in CTEPH may differ from those observed in acute PE. The use of V/Q scan in combination with SPECT or SPECT/CT is becoming more popular than planar scan alone.Comprehensive understanding of the role of V/Q scan in CTEPH will assist in providing early diagnosis, proper therapeutic decision making, and improved prognosis. This review outlines the current roles and potential clinical applications of V/Q scan in the diagnosis and evaluation of CTEPH.
9.The Role of Lung Ventilation/Perfusion Scan in the Management of Chronic Thromboembolic Pulmonary Hypertension
Nuclear Medicine and Molecular Imaging 2024;58(7):449-458
Chronic thromboembolic pulmonary hypertension (CTEPH), which is classified as a group 4 pulmonary hypertension (PH), is a life-threatening complication of acute pulmonary embolism (PE). With the introduction of multidisciplinary approaches and innovative treatment strategies for CTEPH, it is currently regarded not as a fatal disease, but as a curable form of PH.Ventilation/perfusion (V/Q) scan is the preferred imaging method for screening for CTEPH, with superior sensitivity to CT pulmonary angiography. The findings and interpretations of V/Q scan in CTEPH may differ from those observed in acute PE. The use of V/Q scan in combination with SPECT or SPECT/CT is becoming more popular than planar scan alone.Comprehensive understanding of the role of V/Q scan in CTEPH will assist in providing early diagnosis, proper therapeutic decision making, and improved prognosis. This review outlines the current roles and potential clinical applications of V/Q scan in the diagnosis and evaluation of CTEPH.
10.Lexical-semantic Deficit without Semantic Impairment in a Patient with Left Anterior Choroidal Artery Infarction: Neural Correlates Based on Diffusion-tensor Tractography
Han Kyu NA ; Yeeun SUN ; Sangwon JOE ; Chung Seok LEE ; Seokhyun KIM ; Yunjung CHOI ; Haram JOO ; Deog Young KIM ; Hyo Suk NAM
Journal of the Korean Neurological Association 2023;41(3):210-215
A 35-year-old male presented with atypical aphasia following left anterior choroidal artery infarction associated with distal internal carotid artery dissection. He presented with 1) lexical-semantic deficit without semantic impairment, 2) frequent surface errors (both surface dyslexia and dysgraphia), and 3) intact non-word reading/repetition (preserved sub-lexical route), suggesting deficit in the phonological output lexicon. Diffusion-tensor tractography analysis revealed disruption in the inferior fronto-occipital fasciculus and inferior longitudinal fasciculus, which might serve as potential subcortical neural correlates for phonological output lexicon.

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