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Budiawan H, Cheon GJ, Im HJ, Lee SJ, Paeng JC, Kang KW, Chung JK, Lee DS. Heterogeneity Analysis of (18)F-FDG Uptake in Differentiating Between Metastatic and Inflammatory Lymph Nodes in Adenocarcinoma of the Lung: Comparison with Other Parameters and its Application in a Clinical Setting. Nucl Med Mol Imaging 2013; 47:232-41. [PMID: 24900118 DOI: 10.1007/s13139-013-0216-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2013] [Revised: 07/07/2013] [Accepted: 07/11/2013] [Indexed: 12/01/2022] Open
Abstract
PURPOSE Lymph node (LN) characterization is crucial in determining the stage and treatment decisions in patient with lung cancer. Although (18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) has a higher diagnostic accuracy in LN characterization than anatomical imaging, differentiating between metastatic and inflammatory LNs is still challenging because both could show high (18)F-FDG uptake. The purpose of this study was to assess if the heterogeneity of the (18)F-FDG uptake could help in differentiating between inflammatory and metastatic LNs in lung cancer, and to compare with other parameters. METHODS A total of 44 patients with adenocarcinoma of the lung, who underwent preoperative (18)F-FDG PET/CT without having any previous treatments and were revealed to have (18)F-FDG-avid LNs, were enrolled. There were 52 pathology-proven metastatic lymph nodes in 26 subjects. The pathology-proven metastatic LNs were compared with 42 pathology-proven inflammatory/benign LNs in 18 subjects. The coefficient of variation (CV) was used to assess the heterogeneity of (18)F-FDG uptake by dividing the standard deviation of standardized uptake value (SUV) by mean SUV. The volume of interest was manually drawn based on the combined CT images of (18)F-FDG PET/CT (no threshold is used). Comparisons were made with the maximum standardized uptake values (SUVmax), visual assessment of (18)F-FDG uptake, longest diameter, and maximum Hounsfield units (HUmax). RESULTS Metastatic lymph nodes tended to have higher CVs than the inflammatory LNs. The mean CV of metastatic LNs (0.30 ± 0.08; range: 0.08-0.55) was higher than that of inflammatory LNs (0.17 + 0.06; range, 0.07-0.32; P < 0.0001). On receiver operating characteristic (ROC) curve analysis, the area under curve was 0.901, and using 0.20 as cut-off value, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were 88.5 %, 76.2 %, 82.2 %, 84.3, and 83.0 % respectively. Accuracy of CV was slightly higher than SUVmax and diameter, but significantly higher than visual assessment and HUmax. CONCLUSIONS In patients with adenocarcinoma of the lung having no prior treatments, metastatic LNs showed more heterogeneous (18)F-FDG uptake than inflammatory LNs. Measuring the CV of the SUV derived from a manual volume of interest (VOI) can be helpful in determining metastatic LN of adenocarcinoma of the lung. Including diagnostic criteria of CV into the diagnostic approach can increase the accuracy of mediastinal node status.
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Choi H, Yoo MY, Cheon GJ, Kang KW, Chung JK, Lee DS. Parametric Cerebrovascular Reserve Images Using Acetazolamide (99m)Tc-HMPAO SPECT: A Feasibility Study of Quantitative Assessment. Nucl Med Mol Imaging 2013; 47:188-95. [PMID: 24900106 DOI: 10.1007/s13139-013-0214-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2013] [Revised: 06/17/2013] [Accepted: 06/19/2013] [Indexed: 11/30/2022] Open
Abstract
PURPOSE Basal/acetazolamide stress (99m)Tc-HMPAO single-photon emission computed tomography (SPECT) has been widely used for evaluation of hemodynamics; however, qualitative and subjective visual assessment of cerebrovascular reserve (CVR) has been performed in clinical settings. The aim of this study was to generate parametric CVR images and evaluate its feasibility of quantification. METHODS Basal/acetazolamide stress (99m)Tc-HMPAO SPECT data from 17 patients who underwent bypass surgery or percutaneous transluminal angioplasty were used. Spatial normalization was performed and parametric CVR images were generated using relative CVR (rCVR) of each voxel proportional to CVR of the whole brain. Binary parametric maps to show area of relatively reduced CVR were generated also using threshold of rCVR < 90 %. We calculated rCVR of internal carotid artery (ICA) using the parametric CVR images and probabilistic maps for ICA territory. Pre- and postprocedural parametric CVR images were obtained and quantitative rCVRs were compared. The rCVRs were evaluated according to visual grades for regional decreased CVR. RESULTS Postprocedural rCVR obtained from parametric CVR images increased significantly from preprocedural rCVR. The rCVR was significantly correlated with visual grades of reduced CVR for each side of ICA territories. CONCLUSIONS We generated parametric CVR images for basal/acetazolamide stress (99m)Tc-HMPAO SPECT. As a quantitative measurement, rCVR obtained from the parametric image was feasibly assessed hemodynamic abnormalities with preserved anatomical information.
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Chun IK, Cheon GJ, Paeng JC, Kang KW, Chung JK, Lee DS. Detection and Characterization of Parathyroid Adenoma/Hyperplasia for Preoperative Localization: Comparison Between (11)C-Methionine PET/CT and (99m)Tc-Sestamibi Scintigraphy. Nucl Med Mol Imaging 2013; 47:166-72. [PMID: 24900103 DOI: 10.1007/s13139-013-0212-x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2013] [Revised: 04/01/2013] [Accepted: 06/18/2013] [Indexed: 12/19/2022] Open
Abstract
PURPOSE (11)C-Methionine PET/CT (Met-PET/CT) is a useful imaging method for detection of parathyroid adenoma; however, the reported detection rate has been variable. The current study was intended to investigate detection sensitivity and preoperative localization of parathyroid adenoma (PA) or parathyroid hyperplasia (PH) on Met-PET/CT compared with (99m)Tc-sestamibi (MIBI) scintigraphy in patients with primary hyperparathyroidism (HPT) or suspected PA. METHODS Met-PET/CT and MIBI scintigraphy images were reviewed by two nuclear medicine physicians unaware of pathologic results. Detection sensitivities and preoperative localization of detected parathyroid tissues into five predefined segments were evaluated by visual assessment and semi-quantitative analysis with ratio of standardized uptake values (SUVR) between parathyroid tissue and normal lung as reference. Linear regression analysis with SUVR and serum parathyroid hormone (sPTH) was performed for characterization of PA or PH. Predicted PTH (pPTH) was calculated and compared with sPTH in PH and PA. Each pPTH was obtained for a calculated SUVR by using linear regression model from the result of previous linear regression analysis between SUVR and sPTH. RESULTS In 16 patients, detection sensitivities of Met-PET/CT and MIBI scintigraphy were 91.7 % (11/12) and 41.7 % (5/12) for PA and PH including both biopsy-confirmed and clinically-suspected cases, and 100 % (8/8) and 50 % (4/8) for pathologically confirmed PA and PH cases only, respectively. Met-PET/CT showed higher performance than MIBI scintigraphy in localization of parathyroid tissues; correct localization rate was 87.5 % (7/8) on Met-PET/CT and 50 % (4/8) on MIBI scintigraphy. In semi-quantitative analysis, SUVR was linearly associated with sPTH by linear regression analysis (sPTH = 39.53 × SUVR - 89.84, p = 0.0383). There was a borderline significant difference in pPTH between PH and PA (35.1 vs 204.7 ± 164.0, p = 0.052), while there was no significant difference in sPTH between PH and PA (289 vs 230.4 ± 160.4, p = 0.305). CONCLUSIONS Met-PET/CT has a potential to be a useful diagnostic modality for preoperative detection and localization of parathyroid tissues with higher sensitivity than MIBI scintigraphy, and for characterization of PA or PH.
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Kim KI, Park JH, Lee YJ, Lee TS, Park JJ, Song I, Nahm SS, Cheon GJ, Lim SM, Chung JK, Kang JH. In vivo bioluminescent imaging of α-fetoprotein-producing hepatocellular carcinoma in the diethylnitrosamine-treated mouse using recombinant adenoviral vector. J Gene Med 2013; 14:513-20. [PMID: 22761128 DOI: 10.1002/jgm.2648] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The in vivo molecular imaging method is a useful tool for monitoring carcinogenesis in various hepatocellular carcinoma (HCC) models, such as xenografted-, chemical induced- and transgenic mice. The tumor-specific gene expression strategy, such as transcriptional targeting, is essential for achieving a lower toxicity for normal liver tissue in therapy and the monitoring of tumor progression in diagnosis, respectively. The present study aimed to visualize spontaneously developing α-fetoprotein (AFP)-producing HCC through targeted gene expression in tumors using recombinant adenoviral vector. METHODS The recombinant adenovirus vector, AdAFPfLuc (containing firefly luciferase gene driven by human AFP enhancer/promoter) was prepared. After in vitro infection by adenovirus, gene expression was confirmed using the luciferase assay, semi-quantitative reverse transcriptase-polymerase chain reaction and western blotting in AFP-producing and nonproducing cells. Tumor-bearing mice were intravenously injected with adenovirus, and bioluminescent images were obtained. RESULTS The expression of fLuc was efficiently demonstrated by the luciferase assay in AFP-producing cells but not in AFP-nonproducing cells. AFP-producing HCC targeted gene expression was confirmed at the mRNA and protein levels. After being injected intravenously in HuH-7 xenografts and HCC-bearing diethylnitrosamine-treated mice using adenovirus, functional reporter gene expression was confirmed in tumors by in vivo bioluminescent imaging (BLI). CONCLUSIONS The recombinant adenovirus vector system can be used to monitor spontaneously developing AFP-producing HCC and to evaluate targeted gene expression in tumors by in vivo BLI in a small animal model.
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Kim KI, Lee YJ, Lee TS, Song I, Cheon GJ, Lim SM, Chung JK, Kang JH. In vitro radionuclide therapy and in vivo scintigraphic imaging of alpha-fetoprotein-producing hepatocellular carcinoma by targeted sodium iodide symporter gene expression. Nucl Med Mol Imaging 2012; 47:1-8. [PMID: 24895502 DOI: 10.1007/s13139-012-0166-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2012] [Revised: 08/10/2012] [Accepted: 08/20/2012] [Indexed: 12/23/2022] Open
Abstract
PURPOSE This study aimed to develop a gene expression targeting method for specific imaging and therapy of alpha-fetoprotein (AFP)-producing hepatocellular carcinoma (HCC) cells, using an adenovirus vector containing the human sodium/iodide symporter (hNIS) gene driven by an AFP enhancer/promoter. METHODS The recombinant adenovirus vector, AdAFPhNIS (containing the hNIS gene driven by human AFP enhancer/promoter) was prepared. After in vitro infection by the adenovirus, hNIS gene expression in AFP-producing cells and in AFP-nonproducing cells was investigated using (125)I uptake assay and semi-quantitative reverse transcription polymerase chain reaction (RT-PCR). The killing effect of (131)I on AdAFPhNIS-infected HCC cells was studied using an in vitro clonogenic assay. In addition, tumor-bearing mice were intravenously injected with the adenovirus, and scintigraphic images were obtained. RESULTS The expression of hNIS was efficiently demonstrated by (125)I uptake assay in AFP-producing cells, but not in AFP-nonproducing cells. AFP-producing HCC-targeted gene expression was confirmed at the mRNA level. Furthermore, in vitro clonogenic assay showed that hNIS gene expression induced by AdAFPhNIS infection in AFP-producing cells caused more sensitivity to (131)I than that in AFP-nonproducing cells. Injected intravenously in HuH-7 tumor xenografts mice by adenovirus, the functional hNIS gene expression was confirmed in tumor by in vivo scintigraphic imaging. CONCLUSIONS An AFP-producing HCC was targeted with an adenovirus vector containing the hNIS gene using the AFP enhancer/promoter in vitro and in vivo. These findings demonstrate that AFP-producing HCC-specific molecular imaging and radionuclide gene therapy are feasible using this recombinant adenovirus vector system.
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Lee J, Nah KY, Kim RM, Oh YJ, An YS, Yoon JK, An GI, Choi TH, Cheon GJ, Soh EY, Chung WY. Effectiveness of [(124)I]-PET/CT and [(18)F]-FDG-PET/CT for localizing recurrence in patients with differentiated thyroid carcinoma. J Korean Med Sci 2012; 27:1019-26. [PMID: 22969247 PMCID: PMC3429818 DOI: 10.3346/jkms.2012.27.9.1019] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 08/02/2012] [Indexed: 11/20/2022] Open
Abstract
Although the prognosis of patients with differentiated thyroid carcinoma (DTC) is generally encouraging, a diagnostic dilemma is posed when an increasing level of serum thyroglobulin (Tg) is noted, without detection of a recurrent tumor using conventional imaging tools such as the iodine-131 whole-body scanning (the [(131)I] scan) or neck ultrasonography (US). The objective of the present study was to evaluate the diagnostic value of [(124)I]-PET/CT and [(18)F]-FDG-PET/CT in terms of accurate detection of both iodine- and non-iodine-avid recurrence, compared with that of conventional imaging such as the [(131)I] scan or neck ultrasonography (US). Between July 2009 and June 2010, we prospectively studied 19 DTC patients with elevated thyroglobulin levels but who do not show pathological lesions when conventional imaging modalities are used. All involved patients had undergone total thyroidectomy and radioiodine (RI) treatment, and who had been followed-up for a mean of 13 months (range, 6-21 months) after the last RI session. Combined [(18)F]-FDG-PET/CT and [(124)I]-PET/CT data were evaluated for detecting recurrent DTC lesions in study patients and compared with those of other radiological and/or cytological investigations. Nine of 19 patients (47.4%) showed pathological [(18)F]-FDG (5/19, 26.3%) or [(124)I]-PET (4/19, 21.1%) uptake, and were classed as true-positives. Among such patients, disease management was modified in six (66.7%) and disease was restaged in seven (77.8%). In particular, the use of the described imaging combination optimized planning of surgical resection to deal with locoregional recurrence in 21.1% (4/19) of patients, who were shown to be disease-free during follow-up after surgery. Our results indicate that combination of [(18)F]-FDG-PET/CT and [(124)I]-PET/CT affords a valuable diagnostic method that can be used to make therapeutic decisions in patients with DTC who are tumor-free on conventional imaging studies but who have high Tg levels.
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Fang CH, Jin J, Joe JH, Song YS, So BI, Lim SM, Cheon GJ, Woo SK, Ra JC, Lee YY, Kim KS. In vivo differentiation of human amniotic epithelial cells into cardiomyocyte-like cells and cell transplantation effect on myocardial infarction in rats: comparison with cord blood and adipose tissue-derived mesenchymal stem cells. Cell Transplant 2012; 21:1687-96. [PMID: 22776022 DOI: 10.3727/096368912x653039] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Human amniotic epithelial cells (h-AECs), which have various merits as a cell source for cell therapy, are known to differentiate into cardiomyocytes in vitro. However, the ability of h-AECs to differentiate into cardiomyocytes in vivo and their cell transplantation effects on myocardial infarction are still unknown. In this study, we assessed whether h-AECs could differentiate into cardiomyocytes in vivo and whether h-AECs transplantation can decrease infarct size and improve cardiac function, in comparison to transplantation of cord blood-derived mesenchymal stem cells (MSCs) or adipose tissue-derived MSCs. For our study, we injected h-AECs, cord blood-derived MSCs, adipose tissue-derived MSCs, and saline into areas of myocardial infarction in athymic nude rats. After 4 weeks, 3% of the surviving h-AECs expressed myosin heavy chain, a marker specific to the myocardium. Compared with the saline group, all cell-implanted groups showed a higher ejection fraction, lower infarct area by positron emission tomography and histology, and more abundant myocardial gene and protein expression in the infarct area. We showed that h-AECs can differentiate into cardiomyocyte-like cells, decrease infarct size, and improve cardiac function in vivo. The beneficial effects of h-AECs were comparable to those of cord blood and adipose tissue-derived MSCs. These results support the need for further studies of h-AECs as a cell source for myocardial regeneration due to their plentiful availability, low immunity, and lack of ethical issues related to their use.
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Jang SJ, Lee YJ, Lim S, Kim KI, Lee KC, An GI, Lee TS, Cheon GJ, Lim SM, Kang JH. Imaging of a localized bacterial infection with endogenous thymidine kinase using radioisotope-labeled nucleosides. Int J Med Microbiol 2012; 302:101-7. [PMID: 22264560 DOI: 10.1016/j.ijmm.2011.11.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Revised: 09/29/2011] [Accepted: 11/06/2011] [Indexed: 02/05/2023] Open
Abstract
The importance of noninvasive imaging methods to bacterial infections is widely recognized. To obtain bacterial infection imaging with radioisotope-labeled nucleosides, bacterial thymidine kinase (tk) activities of Salmonella typhimurium with [(125)I]5-iodo-1-(2'-fluoro-2'-deoxy-β-d-arabinofuranosyl)uracil ([(125)I]FIAU) or 3'-deoxy-3'-[(18)F]fluorothymidine ([(18)F]FLT) were measured. The infection model in BALB/c mice was imaged with [(125)I]FIAU or [(18)F]FLT using small-animal Single Photon Emission Computed Tomography (SPECT) or Positron Emission Tomography (PET), respectively. The accumulated radioactivity of [(125)I]FIAU or [(18)F]FLT in the two strains showed a linearly increased pattern with increasing incubation time or bacterial numbers. The image clearly demonstrated a high uptake of [(125)I]FIAU and [(18)F]FLT in the bacterial infection site. [(18)F]FLT uptake in the infection site of was 7.286±2.405, whereas that in the uninfected site was 0.519±0.561. The relative activity ratio of the infected region in relation to the uninfected region was 2.98 at 4h after an injection with [(125)I]FIAU determined by biodistribution data. In conclusion, the bacterial tk activity was confirmed by the cellular uptake and imaging with [(125)I]FIAU or [(18)F]FLT. Therefore, a localized bacterial infection in living mice can be monitored using radioisotope-labeled nucleosides with a nuclear medicine imaging modality.
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Park JH, Kim KI, Lee YJ, Lee TS, Kim KM, Nahm SS, Park YS, Cheon GJ, Lim SM, Kang JH. Non-invasive monitoring of hepatocellular carcinoma in transgenic mouse with bioluminescent imaging. Cancer Lett 2011; 310:53-60. [PMID: 21741167 DOI: 10.1016/j.canlet.2011.06.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2011] [Revised: 05/27/2011] [Accepted: 06/09/2011] [Indexed: 02/07/2023]
Abstract
A small animal imaging system for hepatocellular carcinoma (HCC)-specific reporter gene expression will enable monitoring of carcinogenesis or therapeutic intervention in vivo. Transgenic mouse was developed in which firefly luciferase (fLuc) expression was controlled by the AFP enhancer/promoter. The bioluminescent signals of the transgenic neonates were strong at their liver region and decreased after birth. Bioluminescent imaging (BLI) of a transgenic mouse treated with N-nitrosodiethylamine revealed distinct fLuc activity in the liver and an increased pattern with time. The transgenic mouse model can be used to monitor AFP producing HCC by a chemical carcinogen in a live animal by BLI.
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Rho JK, Choi YJ, Jeon BS, Choi SJ, Cheon GJ, Woo SK, Kim HR, Kim CH, Choi CM, Lee JC. Combined treatment with silibinin and epidermal growth factor receptor tyrosine kinase inhibitors overcomes drug resistance caused by T790M mutation. Mol Cancer Ther 2011; 9:3233-43. [PMID: 21159609 DOI: 10.1158/1535-7163.mct-10-0625] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) produce an initially dramatic response in lung cancer patients harboring a mutation in the EGFR gene, development of acquired resistance is almost inevitable. A secondary mutation of threonine 790 (T790M) is associated with approximately half of the cases of acquired resistance. This study investigated whether the addition of silibinin to therapy with gefitinib or erlotinib could overcome T790M-mediated drug resistance considering that silibinin has various antitumor effects, including EGFR modulation. Silibinin selectively reduced the activity of the EGFR family (EGFR, ErbB2, and ErbB3) through the inhibition of receptor dimerization in lung cancer cells with EGFR mutations, but not in those harboring the wild type. In primary and acquired resistant cells with T790M, addition of silibinin enhanced the ability of EGFR-TKIs to downregulate EGFR signals and to inhibit cell growth. Similarly, the combination of silibinin and erlotinib effectively suppressed tumor growth in erlotinib resistance-bearing PC-9 xenografts. The results indicate that the addition of silibinin to EGFR-TKIs is a promising strategy to overcome T790M-mediated drug resistance.
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Na II, Park JY, Kim KM, Cheon GJ, Choe DH, Koh JS, Baek HJ, Lee JC. Significance of smoking history and FDG uptake for pathological N2 staging in clinical N2-negative non-small-cell lung cancer. Ann Oncol 2011; 22:2068-2072. [PMID: 21257671 DOI: 10.1093/annonc/mdq693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND This study was conducted to evaluate whether smoking history and the standardized uptake value (SUV) of 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) uptake are associated with unexpected pathological N2 status (pN2) in non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS We analyzed the data of 220 patients who underwent surgical resection with clinical N2-negative status on computed tomography (CT) and positron emission tomography (PET)-CT. The maximum SUV of primary tumor was chosen for logistic analysis. RESULTS Seventy-two patients (33%) had never smoked. The SUV ranged from 1.0 to 29.0 (median 9.1). In univariate analysis, adenocarcinomas (P = 0.019), female gender (P = 0.010), N1 on CT (P = 0.025), and N1 PET-CT (P = 0.001) were associated with a high probability of pN2. The proportion of pN2 in never smokers was higher than in ever smokers (26% versus 10% respectively; P = 0.002). The SUV remained on a multivariate logistic model (odds ratio 1.1; 95% confidence interval 1.0-1.2; P = 0.010) and it had a better predictive value in never smokers than in ever smokers (P = 0.017). CONCLUSIONS This study indicates an association between smoking history and pN2 in clinically negative N2 NSCLC. The different roles of FDG uptake were also suggested based on smoking history.
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Jun Park J, Sup Lee T, Hyun Kang J, Song R, Jeong Cheon G. Radioiodination and biodistribution of quantum dots using Bolton–Hunter reagent. Appl Radiat Isot 2011; 69:56-62. [DOI: 10.1016/j.apradiso.2010.09.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2010] [Revised: 08/26/2010] [Accepted: 09/02/2010] [Indexed: 11/26/2022]
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Hong MC, Kim YK, Choi JY, Yang SQ, Rhee H, Ryu YH, Choi TH, Cheon GJ, An GI, Kim HY. Synthesis and evaluation of stilbene derivatives as a potential imaging agent of amyloid plaques. Bioorg Med Chem 2010; 18:7724-30. [DOI: 10.1016/j.bmc.2010.06.044] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2009] [Revised: 06/10/2010] [Accepted: 06/15/2010] [Indexed: 10/19/2022]
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Cho AR, Lim I, Na II, Choe DH, Park JY, Kim BI, Cheon GJ, Choi CW, Lim SM. Evaluation of Adrenal Masses in Lung Cancer Patients Using F-18 FDG PET/CT. Nucl Med Mol Imaging 2010; 45:52-8. [PMID: 24899978 DOI: 10.1007/s13139-010-0064-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2010] [Accepted: 10/19/2010] [Indexed: 10/18/2022] Open
Abstract
PURPOSE The aim of this study was to assess the diagnostic efficacy of PET/CT using various parameters for the characterization of adrenal nodules in lung cancer patients. METHODS Sixty-one adrenal nodules in 51 lung cancer patients were evaluated. The final diagnosis was based on histology (n = 2) or imaging follow-up (n = 59, range of follow-up: 7-57 months, median 27 months). Each adrenal nodule was analyzed using four parameters of PET/CT: the maximum standardized uptake value (SUVmax), the adrenal nodule/liver ratio of the SUV (SUV ratio), Hounsfield units (HU) and size. The optimal cutoff of each parameter for the identification of metastatic nodule was determined by ROC analysis and then the diagnostic efficacy was compared among the parameters. RESULTS Of the 61 adrenal nodules, 45 (73%) were considered metastasis. The optimal cutoff values of the parameters were SUVmax >2.7, SUV ratio >1.3, HU >18 and size >20 mm, respectively. The sensitivity, specificity and accuracy by SUVmax >2.7 were 88.9%, 87.5% and 88.5%, and those by SUV ratio >1.3 were 84.4%, 100% and 88.5%, respectively. The combination of SUV ratio >1.3 and HU >18 had sensitivity of 97.7%, specificity of 81.2% and accuracy of 93.4% to predict adrenal metastasis in patients with lung cancer. CONCLUSION SUV ratio from F-18 FDG PET/CT could identify the adrenal metastasis in lung cancer patients. The combination of SUV ratio and HU can improve the accuracy of differentiating benign and metastatic adrenal lesions in lung cancer patients.
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Jang SJ, Kang JH, Kim KI, Lee TS, Lee YJ, Lee KC, Woo KS, Chung WS, Kwon HC, Ryu CJ, Choi TH, Choi CW, Lim SM, Cheon GJ. Application of bioluminescence imaging to therapeutic intervention of herpes simplex virus type I – Thymidine kinase/ganciclovir in glioma. Cancer Lett 2010; 297:84-90. [DOI: 10.1016/j.canlet.2010.04.028] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2010] [Revised: 04/21/2010] [Accepted: 04/30/2010] [Indexed: 10/19/2022]
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Oh YS, Lee TS, Cheon GJ, Jang IS, Jun HS, Park SC. Modulation of insulin sensitivity and caveolin-1 expression by orchidectomy in a nonobese type 2 diabetes animal model. Mol Med 2010; 17:4-11. [PMID: 20844837 DOI: 10.2119/molmed.2009.00105] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2009] [Accepted: 09/09/2010] [Indexed: 11/06/2022] Open
Abstract
Previously, we found that male JYD mice developed type 2 diabetes but female mice did not, and that decreased expression levels of caveolin-1 were correlated with the development of a diabetic phenotype in these mice. Therefore, we hypothesized that sex hormones affect the expression of caveolin-1 and contribute to the development of insulin resistance and hyperglycemia in JYD mice. We used glucose and insulin tolerance tests to examine insulin sensitivity in male, female and orchidectomized male JYD mice. Glucose uptake was analyzed by using (18)F-fluorodeoxyglucose positron emission tomography. We also examined insulin-signaling molecules and caveolin proteins in various tissues in these mice by Western blotting. In addition, we examined changes of caveolin-1 expression in L6 skeletal muscle cells treated with 17-β estradiol or dihydroxytestosterone. We found that glucose and insulin tolerance were impaired and hyperglycemia developed in male, but not female, JYD mice. Expression of insulin-signaling molecules such as insulin receptor, protein kinase B, and glucose transporter-4 were decreased in male JYD mice compared with female mice. Orchidectomized JYD male mice showed improved glucose and insulin tolerance with a concomitant increase in the expression of insulin-signaling molecules and caveolin-1 in adipose tissue and skeletal muscle. Moreover, 17-β-estradiol treatment increased the expression of caveolin-1 in differentiated skeletal muscle cells. We conclude that sex hormones modulate the expression of caveolin-1 and insulin-signaling molecules, subsequently affecting insulin sensitivity and the development of type 2 diabetes in JYD mice.
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Park JY, Lim JS, Park EY, Cho AR, Kim BI, Cheon GJ, Choi CW, Lim SM. The Prevalence and Characteristics of Brown Adipose Tissue in an (18)F-FDG PET Study of Koreans. Nucl Med Mol Imaging 2010; 44:207-12. [PMID: 24899951 DOI: 10.1007/s13139-010-0042-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2010] [Accepted: 07/27/2010] [Indexed: 10/19/2022] Open
Abstract
PURPOSE The object of this study was to evaluate the prevalence and characteristics of brown adipose tissue (BAT) in Korean subjects using (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET). METHODS Six thousand and five consecutive (18)F-FDG PET/CT scans of 5,115 patients (3,007 females and 2,108 males, mean age 53.5 years) were retrospectively reviewed. We characterized the nature of BAT, such as its location, and we assessed the influence of sex, age, body mass index (BMI), and temperature on BAT. RESULTS The prevalence of BAT in Koreans in a single (18)F-FDG PET/CT scan in average conditions was 1.07%. The BAT detection rate was higher in females than males (1.32% vs 0.73%), and also with younger age (7.94% vs 0.73%), lower BMI (BMI with BAT, 21.1 vs BMI without BAT, 23.15) and cold outdoor temperature (1.65% vs 0.49%). The most frequent location of BAT was the supraclavicular area (left, 0.91%; right, 0.88%) and ventral neck area (left, 0.62%; right, 0.63%). CONCLUSIONS The characteristics of BAT in Koreans are not different from those described for Caucasians. However, the low prevalence of BAT in our study might be related to some scan condition like ambient temperature, but further study is needed.
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Jang SJ, Kang JH, Lee TS, Kim SJ, Kim KI, Lee YJ, Cheon GJ, Choi CW, Lim SM. Prodrug-activating Gene Therapy with Rabbit Cytochrome P450 4B1/4-Ipomeanol or 2-Aminoanthracene System in Glioma Cells. Nucl Med Mol Imaging 2010; 44:193-8. [PMID: 24899949 DOI: 10.1007/s13139-010-0038-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Revised: 05/19/2010] [Accepted: 05/24/2010] [Indexed: 10/19/2022] Open
Abstract
OBJECTIVE We determined the cytotoxic properties of cytochrome P450 4B1 (CYP4B1) activated 4-ipomeanol (4-ipo) and 2-aminoanthracene (2-AA) in rat glioma to verify the CYP4B1/4-ipo or 2-AA system for prodrug-activating gene therapy. METHODS The cyp4B1 cDNA was cloned into pcDNA3.1/Hygro from rabbit lung total RNA (pcDNA-cyp4B1). Lentiviral vector encoding firefly luciferase (fLuc) was infected into C6 (rat glioma), and the fLuc-expressing cell was selected (C6-L). After transfection with pcDNA-cyp4B1 vector into C6-L, the single clone expressing cyp4B1 gene was selected (C6-CL). Prodrug for various concentrations of 4-ipo or 2-AA was treated for 72 h and 96 h. The cell survival rate of C6-CL was determined using MTT assay and trypan-blue dye exclusion methods. RESULTS By RT-PCR analysis, fLuc and CYP4B1 expression was detected in C6-CL, but not in C6. MTT assay and trypan-blue dye exclusion showed that IC50 of C6-CL was 0.3 mM and <0.01 mM after 4-ipo or 2-AA treatment at 96 h or 72 h exposure, respectively. Cell survivals of C6-CL were more rapidly reduced after treatment with 4-ipo or 2-AA than those of C6-L cells. The cell survival rate with MTT and trypan-blue dye exclusion assay was well correlated with fLuc activity in C6-CL cells. CONCLUSION CYP4B1-based prodrug-activating gene therapy may have the potential to treat glioma and the cytotoxic effects of CYP4B1 enzyme activated 4-ipo or 2-AA in C6, and could be clearly determined by bioluminescent activity in C6-CL.
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Lee J, Choi Y, Kim K, Hong S, Park HY, Lee T, Cheon GJ, Song R. Characterization and Cancer Cell Specific Binding Properties of Anti-EGFR Antibody Conjugated Quantum Dots. Bioconjug Chem 2010; 21:940-6. [DOI: 10.1021/bc9004975] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Rho JK, Choi YJ, Choi SJ, Cheon GJ, Kim HR, Kim CH, Choi CM, Lee JC. Abstract 620: Addition of silibinin to EGFR-TKIs overcomes T790M-mediated drug resistance. Cancer Res 2010. [DOI: 10.1158/1538-7445.am10-620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Although epidermal growth factor receptor EGFR tyrosine kinase inhibitors (EGFR-TKIs) produce an initially exhibit an initial dramatic response in lung cancer patients harboring a mutation in the EGFR gene, development of acquired resistanceis almost inevitable. The secondary mutation of T790M is associated with approximately one- half of the cases of acquired resistance. In this study, we investigated whether addition of silibinin to gefitinib or erlotinib could overcome T790M-mediated drug resistance considering that silibinin has various anti-tumor effects including EGFR modulation. Silibinin selectively reduced the activity of the EGFR family (EGFR, HER2 and ErbB3) in lung cancer cells with EGFR mutations, but not in those harboring wild type. In primary and acquired resistant cells with T790M, addition of silibinin enhanced the ability of EGFR-TKIs to down-regulate EGFR signals and to inhibit cell growth. Similarly, the combination of silibinin and erlotinib effectively suppressed the tumor growth in erlotinib resistance-bearing PC-9 xenografts. The results indicate that In conclusion, the addition of silibinin to EGFR-TKIs is can be a promising strategy to overcome T790M-mediated drug resistance.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 620.
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Jeong SY, Lee TH, Rhee CH, Cho AR, Il Kim B, Cheon GJ, Choi CW, Lim SM. 3'-Deoxy-3'-[(18)F]fluorothymidine and O-(2-[(18)F]fluoroethyl)-L-tyrosine PET in Patients with Suspicious Recurrence of Glioma after Multimodal Treatment: Initial Results of a Retrospective Comparative Study. Nucl Med Mol Imaging 2010; 44:45-54. [PMID: 24899937 DOI: 10.1007/s13139-009-0007-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2009] [Revised: 11/20/2009] [Accepted: 11/27/2009] [Indexed: 11/30/2022] Open
Abstract
PURPOSE The purpose of this study was to compare the uptakes and diagnostic accuracies between 3'-deoxy-3'-[(18)F]fluorothymidine (FLT) and O-(2-[(18)F]fluoroethyl)-L-tyrosine (FET) PET in patients with a clinical suspicion of having a recurrence of glioma after multimodality treatment. METHODS Thirty-two patients who underwent FLT and FET PET due to abnormal enhancement on magnetic resonance (MR) images were included. According to surgical confirmation or follow-up results, patients were divided into those with therapy-related benign changes (TRBCs) and those with recurrence. Recurrences were divided again into initial low-grade glioma (LGG) and high-grade glioma (HGG). The uptakes of FLT and FET were compared with the maximum standardized uptake value (SUVmax) and lesion-to-normal ratio (LNR). The diagnostic accuracies were compared via a receiver-operating-characteristic (ROC) curve analysis. RESULTS The LNRs of FLT in recurrences with initial HGG (8.26 ± 5.02) were significantly higher than those in recurrences with initial LGG (3.43 ± 2.14) and TRBC (1.81 ± 0.60). The LNRs of FET in recurrence with initial HGG (2.70 ± 0.48) and LGG (3.03 ± 1.32) were significantly higher than those in the TRBC (1.60 ± 0.47). The areas under the ROC curve (AUCs) of FLT and FET for initial LGG were 0.768 and 0.893, respectively. The AUCs of FLT and FET for initial HGG were 1.000 and 0.964. However, there were no statistical significances. The results for comparing with SUVmax were the same as those with LNR. CONCLUSIONS Uptakes of FLT were different according to initial grade in patients with recurrent glioma, but those of FET were not. However, there were no statistical significances in the diagnostic accuracies according to initial grade between the two tracers in this study.
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Na II, Byun BH, Kim KM, Cheon GJ, Choe DH, Koh JS, Lee DY, Ryoo BY, Baek H, Lim SM, Yang SH, Kim CH, Lee JC. 18F-FDG uptake and EGFR mutations in patients with non-small cell lung cancer: a single-institution retrospective analysis. Lung Cancer 2010; 67:76-80. [PMID: 19371962 DOI: 10.1016/j.lungcan.2009.03.010] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2008] [Revised: 03/11/2009] [Accepted: 03/13/2009] [Indexed: 11/30/2022]
Abstract
This retrospective study was performed to evaluate a possible association between the presence of epidermal growth factor receptor (EGFR) mutations and the standardized uptake value (SUV) of (18)F-fluoro-2-deoxy-glucose ((18)F-FDG) uptake in patients with non-small cell lung cancer (NSCLC). We included 100 patients who were tested for EGFR mutations by direct sequencing of resected tissues and who underwent preoperative positron emission tomography/computed tomography at the time of diagnosis. The maximum SUV by the primary tumor was chosen for further analysis. EGFR mutations in exons 19 and 21 were detected in 21 NSCLC patients (21%). EGFR mutations were more frequent in never-smokers than ever-smokers (35% versus 11%; P=0.003), in adenocarcinomas than non-adenocarcinomas (34% versus 6%; P=0.001), and in females than males (41% versus 12%; P=0.001). The SUV ranged from 1.3 to 33.0 (median 10.6). Area under receiver operating characteristic curve for SUVs in respect to the presence of EGFR mutations was 0.74 (95% CI: 0.62-0.85). When a cut off value was used, patients with low SUVs were more likely to have EGFR mutations than those with high SUVs (40% versus 11%; P=0.001). On multivariate analysis, a low SUV remained a significant predictors for EGFR mutations (P=0.025). (18)F-FDG uptake was associated with the presence of EGFR mutation. These results extrapolate that (18)F-FDG uptake might be helpful to discriminate patients who harbor EGFR mutations, especially when a genetic test is not feasible.
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Lim JS, Hwang JS, Lee JA, Kim DH, Park KD, Cheon GJ, Shin CH, Yang SW. Bone mineral density according to age, bone age, and pubertal stages in korean children and adolescents. J Clin Densitom 2010; 13:68-76. [PMID: 19942470 DOI: 10.1016/j.jocd.2009.09.006] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2009] [Revised: 09/18/2009] [Accepted: 09/18/2009] [Indexed: 01/19/2023]
Abstract
To determine whether bone age (BA)-based bone mineral density (BMD) reference values are more accurate than chronological age-based BMD values in predicting the BMD of children who have a discrepancy between their chronological age and BA; we calculated BMD reference values for 514 healthy Korean children (262 girls and 252 boys) aged 5-20yr by dual-energy X-ray absorptiometry. We found that children with BA chronological age discrepancy fitted better to the BA BMD reference curve than to the chronological age BMD reference curve. In contrast, most children without BA-chronological age discrepancy fitted well to both BA and chronological age BMD reference curves, because the 2 reference curves are very similar. In the linear regression analysis, BA-based equations for BMD had a higher R(2) value and lower standard error of estimate than chronological age-based equations. These results indicate that BA-based BMD values are more accurate in predicting BMD in children who have a discrepancy between their BA and chronological age.
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Pandya DN, Kim JY, Park JC, Lee H, Phapale PB, Kwak W, Choi TH, Cheon GJ, Yoon YR, Yoo J. Revival of TE2A; a better chelate for Cu(II) ions than TETA? Chem Commun (Camb) 2010; 46:3517-9. [DOI: 10.1039/b925703a] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kim JS, Lee JS, Park MH, Kim KM, Oh SH, Cheon GJ, Song IC, Moon DH, Chung JK, Lee DS. Feasibility of template-guided attenuation correction in cat brain PET imaging. Mol Imaging Biol 2009; 12:250-8. [PMID: 19949984 DOI: 10.1007/s11307-009-0277-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2009] [Revised: 06/01/2009] [Accepted: 07/01/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE Attenuation correction (AC) is important in quantitative positron emission tomography (PET) imaging of medium-sized animals such as the cat. However, additional time for transmission (TX) scanning and tracer uptake is required in PET studies with animal-dedicated PET scanners because post-injection TX scanning is not available in these systems. The aim of this study was to validate a template-guided AC (TGAC) method that does not require TX PET data for AC in cat 2-deoxy-2-[F-(18)fluoro-D-glucose (FDG) brain PET imaging. METHODS PET scans were acquired using a microPET Focus 120 scanner. TX data were obtained using a (68)Ge point source before the injection of FDG. To generate the attention map (mu-map) template for the TGAC, a target image of emission (EM) PET was selected, and spatial normalization parameters of individual EM data onto the target were reapplied to the corresponding mu-maps. The inverse transformations of the mu-map template into the individual spaces were performed, and the transformed template was forward projected to generate the AC factor. The TGAC method was compared with measured AC (MAC) and calculated AC (CAC) methods using region of interest (ROI) and SPM analyses. RESULTS The ROI analysis showed that the activity of the TGAC EM PET images strongly correlated with those of the MAC data (y = 0.98x + 0.01, R(2) = 0.96). In addition, no significant difference was observed in the SPM analysis. By contrast, the CAC showed a significantly higher uptake in the deep gray regions compared to the MAC (corrected P < 0.05). The ROI correlation with MAC was worse than with the TGAC (R(2) = 0.84). In SPM analysis for the voxel-wise group comparisons between before and after the induction of deafness, only the TGAC showed equivalent results with the MAC. CONCLUSIONS The TGAC was reliable in cat FDG brain PET studies in terms of compatibility with the MAC method. The TGAC might be a useful option for increasing study throughput and decreasing the probability of subject movement. In addition, it might reduce the possible biological effects of long-term anesthesia on the cat brain in investigations using animal-dedicated PET scanners.
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